NPIMap

Organization Active NPI

Lake Pointe Pediatric Associates, P.a.

  • Pediatrics Physician
  • Rowlett, TX
National Provider Identifier
1578656096
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
K5394 Issued in TX
Legal business name
LAKE POINTE PEDIATRIC ASSOCIATES, P.A.
Practice address
6900 Scenic Drive
Suite 103
Rowlett, TX 75088-2695
Phone
(972) 412-1034
Fax
(972) 475-5708
NPI assigned
Oct 2, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Pamela Marion Margaret Wieland, M.D.NPI 1548264880
Title
President
Phone
(972) 412-1034

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X K5394 TX Primary

Addresses

Primary practice location

6900 Scenic Drive
Suite 103
Rowlett, TX 75088-2695

Mailing address

6900 Scenic Drive
Suite 103
Rowlett, TX 75088-2695
Phone (972) 412-1034

Other identifiers 1

IdentifierTypeStateIssuer
0036CVOtherTXBLUE CROSS OF TEXAS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578656096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 SCENIC DRIVE",
            "address_2": "SUITE 103",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750882695",
            "telephone_number": "972-412-1034",
            "fax_number": "972-475-5708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 SCENIC DRIVE",
            "address_2": "SUITE 103",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750882695",
            "telephone_number": "972-412-1034",
            "fax_number": "972-475-5708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE POINTE PEDIATRIC ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WIELAND",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "MARION MARGARET",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-412-1034",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K5394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF TEXAS",
            "identifier": "0036CV",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rowlett, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.