ROCKWALL MEDICAL ASSOCIATION PA NPI 1720207947

NPI Information

NPI: 1720207947
Provider Name: ROCKWALL MEDICAL ASSOCIATION PA
Classification: Pediatrics - 2080A0000X
Entity Type: Organization

Specialization: Adolescent Medicine

Address:
502 W KEARNEY ST
SUITE 700
MESQUITE, TX
ZIP 75149
Phone: (972) 288-7337
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ROCKWALL MEDICAL ASSOCIATION PA is an adolescent medicine pediatrics in Mesquite, TX. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. ROCKWALL MEDICAL ASSOCIATION PA NPI is 1720207947. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

502 W KEARNEY ST
SUITE 700
MESQUITE, TX
ZIP 75149-401
Phone: (972) 288-7337
Fax: (972) 289-9076

The provider's authorized official is Laura S Stiles .
The authorized official title is Physician/owner and has the following contact phone number (972) 288-7337.

The enumeration date for this NPI number is 4/25/2007 and was last updated on 9/21/2012.

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	2080A0000X	Pediatrics	Adolescent Medicine	H8853	TEXAS	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	A13421	MEDICARE UPIN	TEXAS
2	111465401	MEDICAID	TEXAS
3	111465402	MEDICAID	TEXAS

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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