NPIMap

Organization Active NPI

Pediatric Diagnostic Services, PA

  • Pediatrics Physician
  • Irving, TX
National Provider Identifier
1063632891
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC DIAGNOSTIC SERVICES, PA
Doing business as
Kid's Klinic
Practice address
1141 Kinwest Pkwy Ste 150
Irving, TX 75063-3513
Phone
(972) 969-4230
Fax
(214) 496-0267
NPI assigned
Apr 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Authorized official

Name
Dr. Ildiko G Edenhoffer, MDNPI 1689692212
Title
Owner
Phone
(972) 969-4230

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X J7475 TX
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

1141 Kinwest Pkwy Ste 150
Irving, TX 75063-3513

Mailing address

1141 Kinwest Pkwy Ste 150
Irving, TX 75063-3513
Phone (972) 969-4230

Other names 1

  • Kid's Klinic Doing business as

National Provider Directory

National Provider Directory

Locations

1141 Kinwest Pkwy
Ste 150
Irving, TX 75063
Phone (972) 969-4230

9947 N MacArthur Blvd
Irving, TX 75063

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4822/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

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": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658102400000",
    "number": "1063632891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 KINWEST PKWY STE 150",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633513",
            "telephone_number": "972-969-4230",
            "fax_number": "972-409-9016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 KINWEST PKWY STE 150",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633513",
            "telephone_number": "972-969-4230",
            "fax_number": "214-496-0267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DIAGNOSTIC SERVICES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A",
        "authorized_official_last_name": "EDENHOFFER",
        "authorized_official_first_name": "ILDIKO",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-969-4230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "J7475",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kid's Klinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kid's Klinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.