Active NPI
Edith Prichard, MD
- Pediatrics Physician
- Dallas, TX
National Provider Identifier
1184743676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- J1359
- Practice address
- 12606 Greenville Ave Ste 110
Dallas, TX 75243-1908 - Phone
- (214) 292-0072
- Fax
- (214) 292-0044
- NPI assigned
- Mar 28, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | J1359 | TX | Primary |
Addresses
Primary practice location
12606 Greenville Ave Ste 110
Dallas, TX 75243-1908
Mailing address
12606 Greenville Ave Ste 110
Dallas, TX 75243-1908
Phone (214) 292-0072
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 033972303 | Medicaid | TX | |
| 033972302 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J1359 | TX | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234828800000",
"number": "1184743676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12606 GREENVILLE AVE STE 110",
"city": "DALLAS",
"state": "TX",
"postal_code": "752431908",
"telephone_number": "214-292-0072",
"fax_number": "214-292-0044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12606 GREENVILLE AVE STE 110",
"city": "DALLAS",
"state": "TX",
"postal_code": "752431908",
"telephone_number": "214-292-0072",
"fax_number": "214-292-0044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRICHARD",
"first_name": "EDITH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-28",
"last_updated": "2009-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "J1359",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "033972303",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "033972302",
"state": "TX"
}
],
"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 Feb 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.