Rockwall Medical Association, PA

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

H-8853 Issued in TX

Legal business name

ROCKWALL MEDICAL ASSOCIATION, PA

Practice address

114 Kenway St
Rockwall, TX 75087-3536

Phone

(972) 771-1628

Fax

(972) 771-3670

NPI assigned

Mar 19, 2009

Organization subpart

No

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

Authorized official

Name

Laura Shepherd Stiles, DO

Title

Owner

Phone

(972) 771-1628

Specialties & licenses 1

Addresses

Tax ID family

Rockwall Medical Association PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Rockwall Medical Association PA

  • Pediatric Adolescent Medicine Physician
  • Mesquite, TX
  • NPI 1720207947
  NPD tax ID

Locations

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

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237420800000",
    "number": "1386885499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 KENWAY ST",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750873536",
            "telephone_number": "972-771-1628",
            "fax_number": "972-771-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 KENWAY ST",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750873536",
            "telephone_number": "972-771-1628",
            "fax_number": "972-771-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKWALL MEDICAL ASSOCIATION, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-19",
        "last_updated": "2009-03-19",
        "status": "A",
        "authorized_official_last_name": "STILES",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "SHEPHERD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-771-1628",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "TX",
            "license": "H-8853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rockwall Group Health, LLC
• Rockwall Health Center P.L.L.C
• Rockwall Independent School District
• Rockwall Injury Rehab
• Rockwall Isd
• Rockwall Memory Care, LLC (Autumn Leaves of Rockwall)
• Rockwall Modern Dentistry and Orthodontics, PC (Rockwall Modern Dentistry and Orthodontics)
• Rockwall Oral & Facial Surgery
• Rockwall Pediatrics
• Rockwall Pharmacy LLC (Rockwall Pharmacy)

• Pediatric Adolescent Medicine Physician in Rockwall, TX
• Providers in Rockwall, TX by specialty
• Pediatric Adolescent Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2009; 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.