W Pennock Laird MD PA

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

Legal business name

W PENNOCK LAIRD MD PA

Doing business as

Pediatric Heart Specialists

Practice address

12201 Merit Dr Ste 550
Dallas, TX 75251

Phone

(972) 331-9700

Fax

(972) 331-9833

NPI assigned

Nov 16, 2006

Organization subpart

No

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

Authorized official

Name

Vickie J Loose, CMOM

Title

Practice Administrator

Phone

(972) 331-9695

Specialties & licenses 1

Addresses

Other identifiers 13

Other names 1

• Pediatric Heart Specialists Doing business as

Locations

Practitioners 3

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.

• Pooja Desai, M.D.

  • Pediatric Cardiology Physician
  • Dallas, TX
  • NPI 1093945172

  Pediatrics

  NPD (past)
• Colin Edward Kane, M.D.

  • Pediatric Cardiology Physician
  • Dallas, TX
  • NPI 1184809154
  NPD (past)
• Brianna Souder, DO

  • Pediatric Cardiology Physician
  • Tyler, TX
  • NPI 1780115618

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535500800000",
    "number": "1740353598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 MERIT DR STE 550",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752513131",
            "telephone_number": "972-331-9700",
            "fax_number": "972-331-9833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12201 MERIT DR STE 550",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75251",
            "telephone_number": "972-331-9700",
            "fax_number": "972-331-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W PENNOCK LAIRD MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2018-08-29",
        "status": "A",
        "authorized_official_last_name": "LOOSE",
        "authorized_official_first_name": "VICKIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "972-331-9695",
        "authorized_official_credential": "CMOM"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1548450216",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204311909",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370765501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1306834023",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194614707",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1575060003",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157508601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1790773513",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370751501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1417110339",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1518955335",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212234302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1437126364",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Heart Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pediatric Heart Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madhuri Vusirikala, MD
• Valerie Ann Vuylsteke, PHARM.D.
• Juhi Vyas
• W B Carrell Memorial Clinic
• W Dental, PC
• W. Brent Thompson D.C., P.C.
• W. Dennis Stripling, MD PA (North Texas Hand Surgery Associates, Ltd., L.L.P.)
• W. Keith Thornton DDS Inc
• W.a.I.T (We'Re in This Together)
• W.R. Lawley, M.D., P.a. (Keystone Medical Center)

• Pediatric Cardiology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatric Cardiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; 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.