Organization Active NPI

Adolescent and Young Adult Health and Wellness

  • Pediatrics Physician
  • Dallas, TX
National Provider Identifier
1558763086
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
ADOLESCENT AND YOUNG ADULT HEALTH AND WELLNESS
Practice address
16980 Dallas Pkwy Ste 204
Dallas, TX 75248-1910
Phone
(972) 733-6565
Fax
(972) 733-6564
NPI assigned
Sep 16, 2014
Last updated
Apr 25, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Authorized official

Name
Dr. Dana Rubin-Remer, M.D.NPI 1174632053
Title
President
Phone
(972) 733-6565

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

16980 Dallas Pkwy Ste 204
Dallas, TX 75248-1910

Mailing address

16980 Dallas Pkwy Ste 204
Dallas, TX 75248-1910
Phone (972) 733-6565

National Provider Directory

National Provider Directory

Locations

16980 Dallas Pkwy
Ste 204
Dallas, TX 75248
Phone (972) 733-6565

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493078400000",
    "number": "1558763086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16980 DALLAS PKWY STE 204",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481910",
            "telephone_number": "972-733-6565",
            "fax_number": "972-733-6564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16980 DALLAS PKWY STE 204",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481910",
            "telephone_number": "972-733-6565",
            "fax_number": "972-733-6564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADOLESCENT AND YOUNG ADULT HEALTH AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-16",
        "last_updated": "2017-04-25",
        "status": "A",
        "authorized_official_last_name": "RUBIN-REMER",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-733-6565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; 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.