Pediatric Care of Austin PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

F3737 Issued in TX

Legal business name

PEDIATRIC CARE OF AUSTIN PA

Doing business as

Pediatric Care of Austin -South

Practice address

4007 James Casey St
Suite A150
Austin, TX 78745-3369

Phone

(512) 447-0707

Fax

(512) 447-7220

NPI assigned

Oct 23, 2014

Last updated

Oct 23, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rodolfo Barrera, D.O.

Title

President

Phone

(512) 478-4939

Specialties & licenses 1

Addresses

Other names 1

• Pediatric Care of Austin -South Doing business as

Tax ID family

Pediatric Care of Austin2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pediatric Care of Austin, PA

  • Pediatrics Physician
  • Austin, TX
  • NPI 1497959373
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Larry L Lewellyn, D.O.

  • Pediatrics Physician
  • Austin, TX
  • NPI 1821064098
  NPD (past)

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414022400000",
    "number": "1962807776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4007 JAMES CASEY ST",
            "address_2": "SUITE A150",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787453369",
            "telephone_number": "512-447-0707",
            "fax_number": "512-447-7220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4007 JAMES CASEY ST",
            "address_2": "SUITE A150",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787453369",
            "telephone_number": "512-447-0707",
            "fax_number": "512-447-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CARE OF AUSTIN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-23",
        "last_updated": "2014-10-23",
        "status": "A",
        "authorized_official_last_name": "BARRERA",
        "authorized_official_first_name": "RODOLFO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-478-4939",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "F3737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Care of Austin -South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sue Snyder Pederson, MSSW LCSW
• Pedi Spot LLC
• Pediaq LLC
• Pediatric and Allergy Clinic of Austin, PA
• Pediatric Associates of Austin, P.a.
• Pediatric Care of Austin, PA
• Pediatric Critical Care Associates
• Pediatric Dental Professionals, PLLC (Apex Dental Partners)
• Pediatric Home Healthcare, LLC
• Pediatric Partners of Austin, P.a.

• Pediatrics Physician in Austin, TX
• Providers in Austin, 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 23, 2014; 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.