Organization Active NPI

Pediatric Depot PLLC

  • Pediatrics Physician
  • Terrell, TX
National Provider Identifier
1861043259
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC DEPOT PLLC
Practice address
1446 W Moore Ave Ste 206
Terrell, TX 75160-2372
Phone
(972) 210-7350
Fax
(972) 210-7355
NPI assigned
Sep 26, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Authorized official

Name
Roshni Patel, NPNPI 1083956940
Title
Managing Member
Phone
(972) 210-7350

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

1446 W Moore Ave Ste 206
Terrell, TX 75160-2372

Mailing address

1446 W Moore Ave Ste 206
Terrell, TX 75160-2372
Phone (972) 210-7350

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2172780Pediatric Depot1446 West Moore Ave #206, Terrell, TX 75160Certificate of waiverSep 29, 2027

National Provider Directory

National Provider Directory

Locations

1446 W Moore Ave
Ste 206
Terrell, TX 75160
Phone (972) 210-7350

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749600000000",
    "number": "1861043259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1446 W MOORE AVE STE 206",
            "city": "TERRELL",
            "state": "TX",
            "postal_code": "751602372",
            "telephone_number": "972-210-7350",
            "fax_number": "972-210-7355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1446 W MOORE AVE STE 206",
            "city": "TERRELL",
            "state": "TX",
            "postal_code": "751602372",
            "telephone_number": "972-210-7350",
            "fax_number": "972-210-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DEPOT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-26",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "ROSHNI",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "972-210-7350",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terrell, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.