Weatherford Pediatrics, P.a.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

H5445 Issued in TX

Legal business name

WEATHERFORD PEDIATRICS, P.A.

Practice address

712 E Anderson St
Suite a
Weatherford, TX 76086-5873

Phone

(817) 596-7717

Fax

(817) 596-7119

NPI assigned

Jan 4, 2008

Last updated

Jan 4, 2008By 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. Susan Gauntt Walker, M.D.

Title

President

Phone

(817) 596-7717

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan Raedene Gauntt Walker, MD

  • Pediatrics Physician
  • Weatherford, TX
  • NPI 1609970896
  NPD (past)

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199404800000",
    "number": "1730364175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 E ANDERSON ST",
            "address_2": "SUITE A",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865873",
            "telephone_number": "817-596-7717",
            "fax_number": "817-596-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 E ANDERSON ST",
            "address_2": "SUITE A",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865873",
            "telephone_number": "817-596-7717",
            "fax_number": "817-596-7119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEATHERFORD PEDIATRICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-04",
        "last_updated": "2008-01-04",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "GAUNTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-596-7717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "H5445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "89515Z",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120339002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Weatherford Home Care Services LLC (Brazos River Home Health)
• Weatherford Inpatient Physician Association, P. a.
• Weatherford Isd
• Weatherford OB/GYN Associates, P.a.
• Weatherford Pediatrics and Family Medicine, PLLC
• Weatherford Physical Therapy Inc
• Weatherford Podiatry Clinics, P.a.
• Weatherford Point Dentistry, PC (Weatherford Point Dentistry)
• Weatherford Radiology PLLC
• Weatherford Rehabilitation Hospital, LLC (ClearSky Rehabilitation Hospital of Weatherford)

• Pediatrics Physician in Weatherford, TX
• Providers in Weatherford, 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 4, 2008; 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.