Pediatric Clinic of Rockwall, PA

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

H8853 Issued in TX

Legal business name

PEDIATRIC CLINIC OF ROCKWALL, PA

Practice address

6800 Heritage Pkwy
201
Rockwall, TX 75087-8746

Phone

(972) 463-7337

Fax

(972) 463-7004

NPI assigned

Oct 24, 2012

Organization subpart

No

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

Authorized official

Name

Laura Stiles, D.O.

Title

Owner

Phone

(214) 454-9452

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1351036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359072000000",
    "number": "1760735922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 HERITAGE PKWY",
            "address_2": "201",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750878746",
            "telephone_number": "972-463-7337",
            "fax_number": "972-463-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 HERITAGE PKWY",
            "address_2": "201",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750878746",
            "telephone_number": "972-463-7337",
            "fax_number": "972-463-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CLINIC OF ROCKWALL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-24",
        "last_updated": "2013-01-25",
        "status": "A",
        "authorized_official_last_name": "STILES",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-454-9452",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "TX",
            "license": "H8853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pecan Tree Pediatrics, P.a.
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• Pedatric Sleep Solutions, Inc.
• Nicholas Peek
• Derek James Pelletier, PAC
• Angela Peralta, RDN, LD
• Angela Perez, ATC, LAT
• Cynthia Perez, DPT

• Pediatric Adolescent Medicine Physician in Rockwall, TX
• Providers in Rockwall, TX by specialty
• Pediatric Adolescent Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.

Verify at the official NPI Registry.