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SUPERHERO PEDIATRICS PLLC NPI 1821663550


NPI Information

NPI: 1821663550
Provider Name: SUPERHERO PEDIATRICS, PLLC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 45D2180175

Address:
10925 ESTATE LN STE W-302
LYNDON PLAZA WEST
DALLAS, TX
ZIP 75238
Phone: (214) 256-1867
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SUPERHERO PEDIATRICS, PLLC is a pediatrics in Dallas, TX. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. SUPERHERO PEDIATRICS, PLLC NPI is 1821663550. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

10925 ESTATE LN STE W-302
LYNDON PLAZA WEST
DALLAS, TX
ZIP 75238-315
Phone: (214) 256-1867
Fax: (214) 617-0378

The provider's authorized official is Julio Bracero-rodriguez .
The authorized official title is Owner and has the following contact phone number (214) 256-1867.

The CLIA number assigned to this NPI record is 45D2180175 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/25/2021 and was last updated on 7/13/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

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: 4/28/2024

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