Active NPI
Kristen Deann Waw, M.D.
- Pediatrics Physician
- Rowlett, TX
National Provider Identifier
1669684833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- N6763
- Practice address
- 9100 Lakeview Pkwy
Rowlett, TX 75088-4537 - Phone
- (903) 818-3690
- NPI assigned
- May 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | N6763 | TX | Primary |
Addresses
Primary practice location
9100 Lakeview Pkwy
Rowlett, TX 75088-4537
Mailing address
9100 Lakeview Pkwy
Rowlett, TX 75088-4537
Phone (903) 818-3690
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N6763 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Ray Hubbard Pediatrics | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- kwaw459921@direct.sw.org
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatrics Physician
- Rowlett, TX
- NPI 1427061308
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387497600000",
"number": "1669684833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9100 LAKEVIEW PKWY",
"city": "ROWLETT",
"state": "TX",
"postal_code": "750884537",
"telephone_number": "903-818-3690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9100 LAKEVIEW PKWY",
"city": "ROWLETT",
"state": "TX",
"postal_code": "750884537",
"telephone_number": "903-818-3690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAW",
"first_name": "KRISTEN",
"middle_name": "DEANN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2013-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "N6763",
"primary": true
}
],
"identifiers": [],
"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 Dec 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.