Superhero Pediatrics, PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SUPERHERO PEDIATRICS, PLLC

Practice address

10925 Estate LN Ste W-302
Lyndon Plaza West
Dallas, TX 75238-2315

Phone

(214) 256-1867

Fax

(214) 617-0378

NPI assigned

May 25, 2021

Organization subpart

No

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

Authorized official

Name

Julio Bracero-Rodriguez, MD

Title

Owner

Phone

(214) 256-1867

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626134400000",
    "number": "1821663550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10925 ESTATE LN STE W-302",
            "address_2": "LYNDON PLAZA WEST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752382315",
            "telephone_number": "214-256-1867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10925 ESTATE LN STE W-302",
            "address_2": "LYNDON PLAZA WEST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752382315",
            "telephone_number": "214-256-1867",
            "fax_number": "214-617-0378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERHERO PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-07-13",
        "certification_date": "2021-06-19",
        "status": "A",
        "authorized_official_last_name": "BRACERO-RODRIGUEZ",
        "authorized_official_first_name": "JULIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-256-1867",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; 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.