Organization Active NPI

Pediatric & Family Physicians PA

  • Family Medicine Physician
  • Flower Mound, TX
National Provider Identifier
1053531210
Registry record updated Nov 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K5790 Issued in TX
Legal business name
PEDIATRIC & FAMILY PHYSICIANS PA
Practice address
4900 Long Prairie Rd
Suite 100
Flower Mound, TX 75028-2287
Phone
(972) 691-4100
Fax
(972) 691-4118
NPI assigned
Apr 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Harminder S Dhaliwal, MDNPI 1285661140
Title
Partner
Phone
(972) 691-4100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X K5790 TX Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X K4040 TX

Addresses

Primary practice location

4900 Long Prairie Rd
Suite 100
Flower Mound, TX 75028-2287

Mailing address

4900 Long Prairie Rd
Suite 100
Flower Mound, TX 75028-2287
Phone (972) 691-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060220000562 TX Part B Supplier - Clinic/Group Practice 6204841752 Receives reassigned benefits from 4 practitioners
Practice locations: Flower Mound, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0950668Pediatric & Family Physicians PA4900 Long Prairie Road Suite 100a, Flower Mound, TX 75028Certificate of waiverMay 9, 2027

National Provider Directory

National Provider Directory

Locations

2300 Highland Village Rd
Ste 300
Lewisville, TX 75077
Phone (972) 966-1318

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288915200000",
    "number": "1053531210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 LONG PRAIRIE RD",
            "address_2": "SUITE 100",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750282287",
            "telephone_number": "972-691-4100",
            "fax_number": "972-691-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 LONG PRAIRIE RD",
            "address_2": "SUITE 100",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750282287",
            "telephone_number": "972-691-4100",
            "fax_number": "972-691-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC & FAMILY PHYSICIANS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-27",
        "last_updated": "2010-11-05",
        "status": "A",
        "authorized_official_last_name": "DHALIWAL",
        "authorized_official_first_name": "HARMINDER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "972-691-4100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K5790",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K4040",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.