SGH Pediatrics, PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

L4392 Issued in TX

Legal business name

SGH PEDIATRICS, PLLC

Practice address

800 W Arbrook Blvd
Suite 250
Arlington, TX 76015-4327

Phone

(682) 223-1696

Fax

(817) 488-6671

NPI assigned

Oct 29, 2014

Organization subpart

No

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

Authorized official

Name

Stacey Gibson-Hull, M.D.

Title

Owner

Phone

(682) 223-1696

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414540800000",
    "number": "1780089045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W WALL ST",
            "address_2": "SUITE 101",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760517414",
            "telephone_number": "682-223-1696",
            "fax_number": "817-488-6671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W ARBROOK BLVD",
            "address_2": "SUITE 250",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760154327",
            "telephone_number": "682-223-1696",
            "fax_number": "817-488-6671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SGH PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-29",
        "last_updated": "2014-10-29",
        "status": "A",
        "authorized_official_last_name": "GIBSON-HULL",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "682-223-1696",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L4392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Arlington, TX
• Providers in Arlington, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.