Organization Active NPI

Denton Pediatric Physicians PLLC

  • Pediatrics Physician
  • Denton, TX
National Provider Identifier
1528230331
Registry record updated Oct 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
DENTON PEDIATRIC PHYSICIANS PLLC
Practice address
3537 S I-35 E
Suite 207
Denton, TX 76210-6800
Phone
(940) 565-1222
Fax
(940) 565-1220
NPI assigned
Apr 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2008

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

Authorized official

Name
Jeff Henderson
Title
President
Phone
(972) 401-8720

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

3537 S I-35 E
Suite 207
Denton, TX 76210-6800

Mailing address

3537 S I-35 E
Suite 207
Denton, TX 76210-6800
Phone (940) 565-1222

Other identifiers 2

IdentifierTypeStateIssuer
0003RHOtherTXBLUE CROSS BLUE SHIELD
194449801MedicaidTX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224028800000",
    "number": "1528230331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3537 S I-35 E",
            "address_2": "SUITE 207",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762106800",
            "telephone_number": "940-565-1222",
            "fax_number": "940-565-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3537 S I-35 E",
            "address_2": "SUITE 207",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762106800",
            "telephone_number": "940-565-1222",
            "fax_number": "940-565-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTON PEDIATRIC PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-10-15",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-401-8720"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0003RH",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194449801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.