Pediatric Plastic Surgery, PLLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

PEDIATRIC PLASTIC SURGERY, PLLC

Practice address

7777 Forest LN Ste C528
Dallas, TX 75230-6848

Phone

(972) 331-7711

Fax

(972) 331-1911

NPI assigned

Jan 8, 2007

Last updated

Apr 16, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Juli A Smiddy

Title

Practice Administrator

Phone

(972) 331-7711

Specialties & licenses 1

Addresses

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elizabeth B. Clanton, M.D.

  • Plastic Surgery Physician
  • San Antonio, TX
  • NPI 1780864595

  Plastic and Reconstructive Surgery

  NPD (past)
• Frederick J Duffy Jr., M.D.

  • Plastic Surgery Physician
  • Dallas, TX
  • NPI 1376546101

  Single Specialty

  NPD (past)
• Mohamed Elfar, MD

  • Plastic and Reconstructive Surgery Physician
  • Dallas, TX
  • NPI 1457514226
  NPD (past)
• Richard Ha, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Dallas, TX
  • NPI 1609849207
  NPD (past)
• Katina Fowler Hutson, PA-C

  • Physician Assistant
  • Dallas, TX
  • NPI 1487079661
  NPD (past)
• Phileemon Eric Payne, M.D.

  • Plastic Surgery Physician
  • Houston, TX
  • NPI 1548449952
  NPD (past)
• Jason K Potter, M.D., D.D.S.

  • Specialist
  • Dallas, TX
  • NPI 1467449207
  NPD (past)
• Blake Stearns, PC-C

  • Physician Assistant
  • Fort Worth, TX
  • NPI 1780053488
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1558419358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE C528",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752306848",
            "telephone_number": "972-331-7711",
            "fax_number": "972-331-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE C528",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752306848",
            "telephone_number": "972-331-7711",
            "fax_number": "972-331-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PLASTIC SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "SMIDDY",
        "authorized_official_first_name": "JULI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "972-331-7711",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Neurology of Dallas
• Pediatric Neuropsychology Services, PLLC
• Pediatric Ophthalmology PA
• Pediatric Perioperative Consultants of N. TX., PLLC
• Pediatric Plastic Surgery Institute Management, PA
• Pediatric Pulmonary and Sleep Specialists, LLP
• Pediatricians of Dallas, PA (Pediatricians of Dallas)
• Pediatrics of Dallas
• Pediatrics Primary Care Clinic (PPCC)
• Pediatrix Medical Group of Texas Billing, Inc.

• Plastic and Reconstructive Surgery Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Plastic and Reconstructive Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.