NPIMap

Organization Active NPI

Texas Health Presbyterian Hospital Dallas

  • Pediatric Nurse Practitioner
  • Plano, TX
National Provider Identifier
1063577013
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
000431 Issued in TX
Legal business name
TEXAS HEALTH PRESBYTERIAN HOSPITAL DALLAS
Practice address
900 E Park Blvd
Suite 100
Plano, TX 75074-5465
Phone
(214) 345-5634
Fax
(214) 345-7046
NPI assigned
Dec 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Authorized official

Name
Mr. James B
Title
C
Phone
(214) 345-2815

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0200X 000431 TX Primary

Addresses

Primary practice location

900 E Park Blvd
Suite 100
Plano, TX 75074-5465

Mailing address

500 E Border St
Arlington, TX 76010-7445
Phone (214) 345-7260

Other identifiers 1

IdentifierTypeStateIssuer
018093701MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Hospital of Dallas22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776902400000",
    "number": "1063577013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E BORDER ST",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760107445",
            "telephone_number": "214-345-7260",
            "fax_number": "682-236-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E PARK BLVD",
            "address_2": "SUITE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750745465",
            "telephone_number": "214-345-5634",
            "fax_number": "214-345-7046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS HEALTH PRESBYTERIAN HOSPITAL DALLAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A",
        "authorized_official_last_name": "B",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "C",
        "authorized_official_telephone_number": "214-345-2815",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "000431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018093701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.