NPIMap

Organization Active NPI

Centro de Pediatria Hispana, PA

  • Pediatrics Physician
  • Garland, TX
National Provider Identifier
1265989941
Registry record updated Sep 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
L4927 Issued in TX
Legal business name
CENTRO DE PEDIATRIA HISPANA, PA
Practice address
401 W Centerville Rd
Suite 1
Garland, TX 75041-5458
Phone
(972) 840-6500
Fax
(972) 840-6550
NPI assigned
Sep 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2016

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

Authorized official

Name
Roberto Estrada, MD
Title
Owner
Phone
(972) 840-6500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X L4927 TX Primary

Addresses

Primary practice location

401 W Centerville Rd
Suite 1
Garland, TX 75041-5458

Mailing address

401 W Centerville Rd
Suite 1
Garland, TX 75041-5458
Phone (972) 840-6500

Other identifiers 1

IdentifierTypeStateIssuer
1546121904MedicaidTX

National Provider Directory

National Provider Directory

Locations

401 W Centerville Rd
Ste 615
Garland, TX 75041

401 W Centerville Rd
Garland, TX 75041
Phone (972) 840-6500

Practitioners & affiliated clinicians

Practitioners 6

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": "1473379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473379200000",
    "number": "1265989941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W CENTERVILLE RD",
            "address_2": "SUITE 1",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750415458",
            "telephone_number": "972-840-6500",
            "fax_number": "972-840-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W CENTERVILLE RD",
            "address_2": "SUITE 1",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750415458",
            "telephone_number": "972-840-6500",
            "fax_number": "972-840-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO DE PEDIATRIA HISPANA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-09",
        "last_updated": "2016-09-09",
        "status": "A",
        "authorized_official_last_name": "ESTRADA",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-840-6500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L4927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1546121904",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2016; 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.