NPIMap

Organization Active NPI

Pedcare, PA

  • Pediatrics Physician
  • Mesquite, TX
National Provider Identifier
1427375294
Registry record updated May 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDCARE, PA
Practice address
3228 Interstate 30
Suite 300
Mesquite, TX 75150-2633
Phone
(972) 682-1791
Fax
(972) 698-7641
NPI assigned
May 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2010

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

Authorized official

Name
Ms. Belinda Aguilar
Title
Credentialing Coordinator
Phone
(972) 682-1791

Specialties & licenses 1

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

Addresses

Primary practice location

3228 Interstate 30
Suite 300
Mesquite, TX 75150-2633

Mailing address

3228 Interstate 30
Suite 300
Mesquite, TX 75150-2633
Phone (972) 682-1791

Other names 1

  • Kids Wellness Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kids Wellness Center2 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.

Locations

3228 Interstate 30
Ste 300
Mesquite, TX 75150
Phone (972) 682-1791

Practitioners & affiliated clinicians

Practitioners 4

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": "1272844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272844800000",
    "number": "1427375294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3228 INTERSTATE 30",
            "address_2": "SUITE 300",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751502633",
            "telephone_number": "972-682-1791",
            "fax_number": "972-698-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3228 INTERSTATE 30",
            "address_2": "SUITE 300",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751502633",
            "telephone_number": "972-682-1791",
            "fax_number": "972-698-7641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDCARE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-03",
        "last_updated": "2010-05-03",
        "status": "A",
        "authorized_official_last_name": "AGUILAR",
        "authorized_official_first_name": "BELINDA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "972-682-1791",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kids Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesquite, TX

Sources for this page

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