Roland Abou Jaoude, MD
Individual provider Active NPI Pediatrics Physician · Carrollton, TX
NPI 1235360314 · NPPES record last updated Mar 6, 2023
Key facts
- NPI
- 1235360314
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- T9617 (TX)
- Practice address
- 3044 Old Denton Rd Ste 138
Carrollton, TX 75007-5099 - Phone
- (972) 245-0007
- Fax
- (972) 245-9272
- NPI assigned
- Aug 6, 2009
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- Other, 2008
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Suite 1219
Burnet, TX 78611
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251204001831 | TX | Practitioner - Pediatric Medicine | 7416440763 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T9617 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascension Seton | Current |
Accepting new patients | |
| Ascension Seton | Current |
Accepting new patients | |
| Seton Family of Hospitals | Past | Accepting new patients | |
| Ascension Seton | Past | Accepting new patients |
Locations
300 S Colorado St
Ste B
Lockhart, TX 78644
Phone (512) 376-3377
130 Hays St
Ste Bd
Luling, TX 78648
Phone (830) 875-7000
Interoperability endpoints
- roland.abou.jaoude.1@8363.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | T9617 | TX | Yes |
Addresses
Primary practice location
3044 Old Denton Rd Ste 138
Carrollton, TX 75007-5099
Mailing address
12377 Merit Dr Ste 300
Dallas, TX 75251-3126
Phone (972) 957-3000
Other providers in Carrollton, TX
- Hussein Abdel Aziz
- Semira Abdourezak
- Robin Carol Abels
- Fatima Abimbola
- Omar Aborahma
- Annie Abraham
- Krystal Sunny Abraham
- Simi Abraham
- Mark Abrinica
- Abs Labs LLC
All providers in Carrollton, TX · Pediatrics Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.