Central Texas Pediatrics

Primary specialty

SpecialistTaxonomy code 174400000X

License

J3846 Issued in TX

Legal business name

CENTRAL TEXAS PEDIATRICS

Practice address

1607 Lake Success Dr
Waco, TX 76710-2908

Phone

(254) 772-0783

NPI assigned

Sep 24, 2007

Reactivated

Jan 7, 2013

Organization subpart

No

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

Authorized official

Name

Sudhir Madisetty, MDNPI 1588672760

Title

Owner

Phone

(254) 772-0783

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sudhir Madisetty, M.D.

  • Pediatrics Physician
  • Waco, TX
  • NPI 1588672760

  Specialist

  NPD (past) Authorized official
• Maria Araceli Maldonado, RN, MSN, FNP-C

  • Family Nurse Practitioner
  • Waco, TX
  • NPI 1275848327
  NPD (past)

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396483200000",
    "number": "1306032248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 LAKE SUCCESS DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767102908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 LAKE SUCCESS DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767102908",
            "telephone_number": "254-772-0783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL TEXAS PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2014-04-03",
        "deactivation_date": "2010-07-27",
        "reactivation_date": "2013-01-07",
        "status": "A",
        "authorized_official_last_name": "MADISETTY",
        "authorized_official_first_name": "SUDHIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "254-772-0783",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "J3846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Waco, TX
• Providers in Waco, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.