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PEDCARE PA NPI 1417177841


NPI Information

NPI: 1417177841
Provider Name: PEDCARE, PA

Doing Business As: PEDIATRIC CLINIC OF MESQUITE

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 45D1060381

Address:
3230 INTERSTATE 30
SUITE 100
MESQUITE, TX
ZIP 75150
Phone: (972) 682-1791
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PEDCARE, PA is a pediatrics in Mesquite, 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. PEDCARE, PA NPI is 1417177841. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Pediatric Clinic Of Mesquite.

The provider's business location address is:

3230 INTERSTATE 30
SUITE 100
MESQUITE, TX
ZIP 75150
Phone: (972) 682-1791

The provider's authorized official is Mona Lafontaine .
The authorized official title is Manager and has the following contact phone number (972) 682-1791.

The CLIA number assigned to this NPI record is 45D1060381 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/26/2007 and was last updated on 8/22/2020.


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
1208000000XPediatricsK3364TEXASYes

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: 5/5/2024

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