Davida J. Wardell, MD PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

DAVIDA J. WARDELL, MD PA

Practice address

111 Medical Dr
Palestine, TX 75801-4781

Phone

(903) 729-5333

NPI assigned

May 24, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Sandra Whitworth

Title

Billing Supervisor

Phone

(903) 727-0110

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1274659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277337600000",
    "number": "1295054757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MEDICAL DR",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758014781",
            "telephone_number": "903-729-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MEDICAL DR",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758014781",
            "telephone_number": "903-729-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIDA J. WARDELL, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-24",
        "last_updated": "2010-06-24",
        "status": "A",
        "authorized_official_last_name": "WHITWORTH",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "903-727-0110",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Palestine, TX
• Providers in Palestine, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; 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.