Northside Pediatrics, PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

NORTHSIDE PEDIATRICS, PLLC

Practice address

1200 Jupiter Rd # 940683
Plano, TX 75074-7017

Phone

(682) 305-7890

NPI assigned

Jan 27, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Jaeon Abraham, MDNPI 1043638885

Title

Manager

Phone

(214) 674-9189

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jaeon Abraham, M.D.

  • Pediatrics Physician
  • Plano, TX
  • NPI 1043638885
  NPD Authorized official

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

{
    "created_epoch": "1674777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674777600000",
    "number": "1629784194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 W MUIRFIELD RD",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750444233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 JUPITER RD # 940683",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750747017",
            "telephone_number": "682-305-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-27",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-26",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "JAEON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "214-674-9189",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Texas Village Health Partners, PA
• North Texas Vision Associates
• Avery Elizabeth North
• Taylor North, RD
• Northern Bay Womens Health Center, PA
• Chelsea Norwine
• Erick Norwood, PA-C
• Shannon Norwood, RD, LD
• Iriagbonese Nosakhare
• Osarodion Kingsley Nosakhare, PHARMD

• Pediatrics Physician in Plano, TX
• Providers in Plano, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; 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.