NPIMap

Organization Active NPI

Old Town Pediatrics of Mesquite PA

  • Pediatric Adolescent Medicine Physician
  • Mesquite, TX
National Provider Identifier
1609165109
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
H8853 Issued in TX
Legal business name
OLD TOWN PEDIATRICS OF MESQUITE PA
Practice address
502 W Kearney St
Suite 700
Mesquite, TX 75149-3401
Phone
(972) 288-7337
Fax
(972) 289-9076
NPI assigned
Apr 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Authorized official

Name
Dr. Laura S Stiles, D.O.
Title
President
Phone
(972) 288-7337

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080A0000X H8853 TX Primary

Addresses

Primary practice location

502 W Kearney St
Suite 700
Mesquite, TX 75149-3401

Mailing address

502 W Kearney St
Suite 700
Mesquite, TX 75149-3401
Phone (972) 288-7337

National Provider Directory

National Provider Directory
Tax ID family
Old Town Pediatrics of Mesquite PA2 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.

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301961600000",
    "number": "1609165109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 W KEARNEY ST",
            "address_2": "SUITE 700",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751493401",
            "telephone_number": "972-288-7337",
            "fax_number": "972-289-9076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 W KEARNEY ST",
            "address_2": "SUITE 700",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751493401",
            "telephone_number": "972-288-7337",
            "fax_number": "972-289-9076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD TOWN PEDIATRICS OF MESQUITE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-05",
        "last_updated": "2011-04-05",
        "status": "A",
        "authorized_official_last_name": "STILES",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-288-7337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "TX",
            "license": "H8853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 5, 2011; 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.