PEDIAQ TEXAS LLC NPI 1326415779

NPI Information

NPI: 1326415779
Provider Name: PEDIAQ TEXAS LLC
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Organization

Specialization: Pediatrics

Address:
17101 PRESTON RD
STE 115
DALLAS, TX
ZIP 75248
Phone: (214) 984-3900
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PEDIAQ TEXAS LLC is a pediatrics nurse practitioner in Dallas, TX. PEDIAQ TEXAS LLC NPI is 1326415779. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

17101 PRESTON RD
STE 115
DALLAS, TX
ZIP 75248-331
Phone: (214) 984-3900
Fax: (972) 294-3343

The provider's authorized official is Jon Osullivan .
The authorized official title is Owner and has the following contact phone number 21498439000.

The enumeration date for this NPI number is 9/1/2015 and was last updated on 9/1/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0222X	Nurse Practitioner	Pediatrics, Critical Care	226944	TEXAS	No
2	363LP0200X	Nurse Practitioner	Pediatrics			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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