Fort Worth Med-Peds Associates P.a.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

L2552 Issued in TX

Legal business name

FORT WORTH MED-PEDS ASSOCIATES P.A.

Practice address

4545 Bellaire Dr S
Suite 9
Fort Worth, TX 76109-1889

Phone

(817) 732-6060

Fax

(817) 731-2541

NPI assigned

Feb 19, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stuart Charles Pickell, MD

Title

Owner

Phone

(817) 732-6060

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689718975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 BELLAIRE DR S",
            "address_2": "SUITE 9",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091889",
            "telephone_number": "817-732-6060",
            "fax_number": "817-731-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 BELLAIRE DR S",
            "address_2": "SUITE 9",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091889",
            "telephone_number": "817-732-6060",
            "fax_number": "817-731-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WORTH MED-PEDS ASSOCIATES P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PICKELL",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-732-6060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "L2552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Primary Care Clinic/Center in Texas

• 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.