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GRAPEVINE PEDIATRIC CLINIC PA NPI 1710010418


NPI Information

NPI: 1710010418
Provider Name: GRAPEVINE PEDIATRIC CLINIC, PA
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
1600 W COLLEGE ST STE 60
GRAPEVINE, TX
ZIP 76051
Phone: (817) 488-7334
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GRAPEVINE PEDIATRIC CLINIC, PA is a medical specialty clinic center in Grapevine, TX. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). GRAPEVINE PEDIATRIC CLINIC, PA NPI is 1710010418. The provider is registered as an organization entity type.

The provider's business location address is:

1600 W COLLEGE ST STE 60
GRAPEVINE, TX
ZIP 76051-580
Phone: (817) 488-7334
Fax: (817) 421-6527

The provider's authorized official is Anthony Mark Scott .
The authorized official title is President and has the following contact phone number (817) 488-7334.

The enumeration date for this NPI number is 3/13/2007 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
1261QM2500XClinic/CenterMedical SpecialtyTEXASYes

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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