Individual provider Active NPI

Terrie Pak

  • Pediatrics Physician
  • Cypress, TX
National Provider Identifier
1114338860
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R3395 Issued in TX
Practice address
27700 Northwest Fwy Ste 440
Cypress, TX 77433-6767
Phone
(832) 334-4011
NPI assigned
May 15, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R3395 TX Primary

Addresses

Primary practice location

27700 Northwest Fwy Ste 440
Cypress, TX 77433-6767

Mailing address

27700 Northwest Fwy Ste 440
Cypress, TX 77433-6767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160425001387 TX Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 4789983826

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R3395TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Fish Pediatrics, L.L.P. Pediatrics PastSince Sep 8, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1114338860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27700 NORTHWEST FWY STE 440",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774336767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27700 NORTHWEST FWY STE 440",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774336767",
            "telephone_number": "832-334-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAK",
        "first_name": "TERRIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-15",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R3395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

Verify at the official NPI Registry.