Fairway Pediatrics, PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

K6737 Issued in TX

Legal business name

FAIRWAY PEDIATRICS, PLLC

Practice address

4100 Fairway Dr
Suite 300
Carrollton, TX 75010-6525

Phone

(972) 492-8880

Fax

(972) 492-8818

NPI assigned

Oct 6, 2012

Organization subpart

No

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

Authorized official

Name

Jian Wang, MDNPI 1528043882

Title

Owner

Phone

(469) 855-2073

Specialties & licenses 1

Addresses

Other identifiers 1

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

CLIA laboratory certificates

Locations

Practitioners 2

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

• Jian Wang, MD

  • Pediatrics Physician
  • Carrollton, TX
  • NPI 1528043882
  NPD (past) Authorized official
• Miaojuan Li, RN, CPNP

  • Pediatric Nurse Practitioner
  • Carrollton, TX
  • NPI 1326404393
  NPD (past)

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

{
    "created_epoch": "1349481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357516800000",
    "number": "1821340472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 FAIRWAY DR",
            "address_2": "SUITE 300",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750106525",
            "telephone_number": "972-492-8880",
            "fax_number": "972-492-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 FAIRWAY DR",
            "address_2": "SUITE 300",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750106525",
            "telephone_number": "972-492-8880",
            "fax_number": "972-492-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRWAY PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-06",
        "last_updated": "2013-01-07",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "JIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-855-2073",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K6737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3079857-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• F&R Medical Solutions, LLC
• Joanne Madeline Fabrick, MA, LPC
• Mitchell Franklin Fagelman, M.D.
• Fair Acres Emergency Physicians, PLLC
• Fairway Family Medicine-Primary Care, PLLC
• Shireen Faisal, DNAP
• Shantell Marie Faithful
• Huma Fakhr
• Meghan L Faller, RN
• Family Care Medical Center

• Pediatrics Physician in Carrollton, TX
• Providers in Carrollton, 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 7, 2013; 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.