PEDS CENTER OF ROUND ROCK PA (NPI# 1013492420) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013492420 |
| Entity Type | Organization |
| Organization Name | PEDS CENTER OF ROUND ROCK PA |
| Practice Address |
1701 N Loop 250 W Midland TX 79707-6002 |
| Practice Telephone | 4325225033 |
| Practice Fax Number | 4325225077 |
| Mailing Telephone | 4325225033 |
| Mailing Fax Number | 4325225077 |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2018-10-02 |
| Authorized Official Name | VIVEKANAND DASARI (OWNER) |
| Authorized Official Telephone | 2012897621 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Midland Clinic | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417578501 | Peds Center of Round Rock Pa | Pediatrics | 1301 Medical Pkwy Ste 310, Cedar Park, TX 78613-2529 | 2020-04-30 |
| 1033767975 | Peds Center of Round Rock Pa | Pediatrics | 218 W Us Highway 290, Elgin, TX 78621-3265 | 2019-09-03 |
| 1477113223 | Peds Center of Round Rock Pa | Pediatrics | 12411 Hymeadow Dr Ste 3f, Austin, TX 78750-1829 | 2019-06-14 |
| 1316413958 | Peds Center of Round Rock Pa | Pediatrics | 1015 E 32nd St Ste 203, Austin, TX 78705-2700 | 2018-10-22 |
| 1588149991 | Peds Center of Round Rock Pa | Pediatrics | 420 E 6th St Ste 203, Odessa, TX 79761-4572 | 2018-10-02 |
| 1508370701 | Peds Center of Round Rock Pa | Pediatrics | 1526 Leander Rd, Georgetown, TX 78628-8801 | 2017-11-27 |
| Street Address |
1701 N LOOP 250 W |
| City | MIDLAND |
| State | TX |
| Zip Code | 79707-6002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770673113 | Texas Tech University Health Sciences Center | Internal Medicine | 1701 N Loop 250 W, Midland, TX 79707-6002 | 2006-10-14 |
| 1033597406 | Vicky Bakhos Webb | Family Medicine | 1701 N Loop 250 W, Midland, TX 79707-6002 | 2015-05-18 |
| 1225381908 | Mickey D Thomas | Nurse Practitioner | 1701 N Loop 250 W, Midland, TX 79707-6002 | 2012-10-18 |
| 1417231044 | Angela Leanne Madewell | Nurse Practitioner | 1701 N Loop 250 W, Midland, TX 79707-6002 | 2011-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548861164 | Daniel & Max, LLC | Optometrist | 3110 N Loop 250 W, Suite 200, Midland, TX 79707 | 2020-11-02 |
| 1396196036 | Endurance Inc | Pharmacy | 4906 Briarwood, Midland, TX 79707 | 2016-06-23 |
| 1841683356 | Carson Riley Phillips | Dentist | 4425 W Wadley Ave Ste 100, Midland, TX 79707 | 2015-03-07 |
| 1336538610 | Permian Basin Er II | Clinic/Center | 3201 N. Midland Drive, Ste 130, Midland, TX 79707 | 2015-01-09 |
| 1659776342 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 5315 Briarwood Ave, Midland, TX 79707 | 2014-10-24 |
| 1982958799 | Tara Rae Nagel | Nurse Practitioner | 4214 Mamies Cir, Midland Pediatric Associates, Midland, TX 79707 | 2012-10-31 |
| 1336432046 | Ashley Thrasher Bell | Physician Assistant | 3600 N Garfield, Ttuhsc Pa Program, Midland, TX 79707 | 2011-05-27 |
| 1053626622 | Jerry Milton Lyon | Nurse Practitioner | 5000 Briarwood Ave Ste 203, Midland, TX 79707 | 2010-08-08 |
| 1053645838 | Marta Willoughby Md Pa | Clinic/Center | 3423 Caldera, Midland, TX 79707 | 2009-09-25 |
| 1326251950 | Bonnie Lloyd Clemmer | Registered Nurse | 3600 W Loop 250 North, Apt 1083, Midland, TX 79707 | 2007-05-08 |
| Find all providers in zip 79707 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700315587 | Mia Centauri Marshall | Pediatrics | 4214 Andrews Hwy Fl 6, Midland, TX 79703-4822 | 2017-06-06 |
| 1548556228 | Celecia Byfield | Pediatrics | 2500 Delano Ave Fl 1, Midland, TX 79701-6357 | 2011-06-21 |
| 1841594165 | Sudhi Agrawal | Pediatrics | 4475 Hackberry Ct, Midland, TX 79707-1614 | 2010-12-29 |
| 1174783641 | Barbara Jean Wood | Pediatrics | 3415 Caldera Blvd, Midland, TX 79707-2825 | 2008-06-09 |
| 1346416542 | Wf Ballesteros Md | Pediatrics | 3901 Fairwood Ct, Midland, TX 79707-1428 | 2008-05-07 |
| 1043484934 | Adam John Hamilton | Pediatrics | 4401 Campus Ridge Dr Ste 2000, Midland, MI 48640-6125 | 2008-04-22 |
| 1427239078 | W Ballesteros Ltd LLP | Pediatrics | 5304 Castle Pine Rd, Midland, TX 79707-3204 | 2007-11-23 |
| 1124218847 | Premier Family Care I, Inc. | Pediatrics | 1900 W. Wall, Suite A, Midland, TX 79701-6534 | 2007-07-30 |
| 1093928913 | Chandan Mazumder | Pediatrics | 1900 W Wall St Ste C, Midland, TX 79701-6568 | 2007-05-07 |
| 1194813709 | Tareq Hulali | Pediatrics | 3421 Caldera Blvd, Midland, TX 79707-2825 | 2006-10-10 |
| Find all providers in MIDLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.