Organization Active NPI

Greater North Texas Pediatrics PA

  • Pediatrics Physician
  • Dallas, TX
National Provider Identifier
1720189491
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G9023 Issued in TX
Legal business name
GREATER NORTH TEXAS PEDIATRICS PA
Practice address
12200 Park Central Drive #255
Dallas, TX 75251
Phone
(214) 553-0705
Fax
(214) 553-0706
NPI assigned
Sep 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Authorized official

Name
Steven Todd Brockett
Title
Office Manager
Phone
(214) 553-0705

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X G9023 TX Primary

Addresses

Primary practice location

12200 Park Central Drive #255
Dallas, TX 75251

Mailing address

12200 Park Central Drive #255
Dallas, TX 75251
Phone (214) 553-0705

Other names 1

  • Forest Hills Pediatrics PA Former legal business name

National Provider Directory

National Provider Directory

Locations

12200 Park Central Dr
Ste 255
Dallas, TX 75251
Phone (214) 553-0705

9304 Forest Ln
Ste 150
Dallas, TX 75243

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1720189491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 PARK CENTRAL DRIVE #255",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75251",
            "telephone_number": "214-553-0705",
            "fax_number": "214-553-0706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 PARK CENTRAL DRIVE #255",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75251",
            "telephone_number": "214-553-0705",
            "fax_number": "214-553-0706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER NORTH TEXAS PEDIATRICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "BROCKETT",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "214-553-0705"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "G9023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forest Hills Pediatrics PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.