NPIMap

Organization Active NPI

Forney Pediatric & Medical Clinic P.a.

  • Pediatric Adolescent Medicine Physician
  • Forney, TX
National Provider Identifier
1346305117
Registry record updated Nov 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
G2825 Issued in TX
Legal business name
FORNEY PEDIATRIC & MEDICAL CLINIC P.A.
Practice address
713 W Broad St
Suite 100
Forney, TX 75126
Phone
(972) 552-3330
Fax
(972) 552-3303
NPI assigned
Dec 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2008

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

Authorized official

Name
Jayaprakash Narayan Reddy, MD
Title
President
Phone
(972) 552-3330

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X G4198 TX
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X G4198 TX
Pediatric Adolescent Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080A0000X G2825 TX Primary

Addresses

Primary practice location

713 W Broad St
Suite 100
Forney, TX 75126

Mailing address

713 W Broad St
Suite 100
Forney, TX 75126
Phone (972) 552-3330

Other names 1

  • Forney Pediatric & Medical Clinic, P.A. Former legal business name

National Provider Directory

National Provider Directory

Locations

713 W Broad St
Ste 100
Forney, TX 75126
Phone (972) 552-3330

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226620800000",
    "number": "1346305117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 W BROAD ST",
            "address_2": "SUITE 100",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "75126",
            "telephone_number": "972-552-3330",
            "fax_number": "972-552-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 W BROAD ST",
            "address_2": "SUITE 100",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "75126",
            "telephone_number": "972-552-3330",
            "fax_number": "972-552-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORNEY PEDIATRIC & MEDICAL CLINIC P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2008-11-14",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "JAYAPRAKASH",
        "authorized_official_middle_name": "NARAYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-552-3330",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G4198",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "G4198",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "TX",
            "license": "G2825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forney Pediatric & Medical Clinic, P.A.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Forney, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2008; 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.