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PEDIATRICS CARE CLINIC NPI 1003006669


NPI Profile

NPI: 1003006669
Provider Name: PEDIATRICS CARE CLINIC
Classification:Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 45D0968949

Address:
5506 BROADWAY BLVD
GARLAND, TX
ZIP 75043
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Phone: (972) 303-0240

PEDIATRICS CARE CLINIC is a pediatrics in Garland, 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. PEDIATRICS CARE CLINIC NPI is 1003006669. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5506 BROADWAY BLVD
GARLAND, TX
ZIP 75043-639
Phone: (972) 303-0240
Fax: (972) 303-4343

The provider's authorized official is Lubna Kamal .
The authorized official title is Head Physician/owner and has the following contact phone number (972) 303-2400.

The CLIA number assigned to this NPI record is 45D0968949 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/30/2007 and was last updated on 5/29/2008.


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
1208000000XPediatricsK2224TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10049EBOTHERTEXASBLUE SHIELD
2092381501MEDICAIDTEXAS
3093881502MEDICAIDTEXAS

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: 6/14/2021

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