Organization Active NPI

Mek Pediatrics, PLLC

  • Pediatrics Physician
  • Dallas, TX
National Provider Identifier
1124276175
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MEK PEDIATRICS, PLLC
Practice address
11661 Preston Rd Ste 120
Dallas, TX 75230-6199
Phone
(972) 596-2134
NPI assigned
Sep 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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

Authorized official

Name
Russel R McDonald, M.D.
Title
President
Phone
(972) 596-2134

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X TX Primary

Addresses

Primary practice location

11661 Preston Rd Ste 120
Dallas, TX 75230-6199

Mailing address

11661 Preston Rd #120
Dallas, TX 75230

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414022400000",
    "number": "1124276175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11661 PRESTON RD #120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11661 PRESTON RD STE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752306199",
            "telephone_number": "972-596-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEK PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2014-10-23",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "RUSSEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-596-2134",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; 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.