PEDIATRIC CENTER OF GRAND PRAIRIE (NPI# 1114323862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114323862 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC CENTER OF GRAND PRAIRIE |
| Practice Address |
4927 Lake Ridge Pkwy Suite 120 Grand Prairie TX 75052-3087 |
| Mailing Address |
701 Tuscan Dr Suite 285 Irving TX 75039-4133 |
| Practice Telephone | 9724010700 |
| Mailing Telephone | 9724010700 |
| Enumeration Date | 2014-11-07 |
| Last Update Date | 2014-11-07 |
| Authorized Official Name | SUE E SCHLEIER (PHYSICIAN) |
| Authorized Official Telephone | 9724010700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | N6133 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
4927 LAKE RIDGE PKWY SUITE 120 |
| City | GRAND PRAIRIE |
| State | TX |
| Zip Code | 75052-3087 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114919677 | Carolyn K Kha | Optometrist | 4927 Lake Ridge Pkwy, Suite Number 160, Grand Prairie, TX 75052-3073 | 2005-08-19 |
| 1386252831 | Claire Knobbe | Behavioral Analyst | 4927 Lake Ridge Pkwy, Grand Prairie, TX 75052-3087 | 2020-07-21 |
| 1053887190 | Ashleigh Mills | Behavior Technician | 4927 Lake Ridge Pkwy, Grand Prairie, TX 75052-3087 | 2018-10-16 |
| 1205211174 | Applewhite Dental Pllc | Dentist | 4927 Lake Ridge Pkwy, Suite 140, Grand Prairie, TX 75052-3087 | 2015-07-21 |
| 1124314737 | Miranda Efua Wellington | Family Medicine | 4927 Lake Ridge Pkwy, Suite 100, Grand Prairie, TX 75052-3087 | 2011-06-22 |
| 1912169210 | Omar Hernandez | Family Medicine | 4927 Lake Ridge Pkwy, Suite 100, Grand Prairie, TX 75052-3087 | 2008-06-27 |
| 1497915623 | Jeaneen Chappell | Dermatology | 4927 Lake Ridge Pkwy, Grand Prairie, TX 75052-3087 | 2008-06-11 |
| 1275609224 | Ramona Applewhite Taylor | Dentist | 4927 Lake Ridge Pkwy, Ste 140, Grand Prairie, TX 75052-3087 | 2006-11-28 |
| 1558450452 | Lake Ridge Eye Care Pa | Optometrist | 4927 Lake Ridge Pkwy, Ste. 160, Grand Prairie, TX 75052-3073 | 2006-10-11 |
| 1609800911 | Marsha Cox | Nurse Practitioner | 4927 Lake Ridge Pkwy, Grand Prairie, TX 75052-3073 | 2006-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487265542 | Beyond Home Health Care LLC | Registered Nurse | 3531 Pecos Way, Grand Prairie, TX 75052 | 2020-08-12 |
| 1497370332 | Michael Cooper | Dentist | 3154 South Hwy 161 Ste 640, Grand Prairie, TX 75052 | 2020-06-16 |
| 1043835788 | Amanda Azubike | Licensed Practical Nurse | 4593 Mt Laurel Dr, Grand Prairie, TX 75052 | 2020-06-09 |
| 1457992844 | Epic West Family Dnetistry Pllc | Dentist | 3166 Sh 161, Ste 190, Grand Prairie, TX 75052 | 2019-10-07 |
| 1033777487 | National Vision Inc | Optometrist | 3166 South Highway 161, Suite 160, Grand Prairie, TX 75052 | 2019-05-31 |
| 1689136624 | Raushanah Taherrah Shareef-jefferson | Dental Hygienist | 831 Ridgecrest Rd, Grand Prairie, TX 75052 | 2019-04-01 |
| 1053812552 | Dfw Better Care Physicians, Pllc | Clinic/Center | 5204 Tx 360 #400, Grand Prairie, TX 75052 | 2018-02-21 |
| 1629586797 | Grand Prairie Marvel Dental Pllc | Clinic/Center | 5020 S Hwy 360, Suite 200, Grand Prairie, TX 75052 | 2018-01-11 |
| 1033626221 | Thad Taylor Iv Dds | Dentist | 3261 S. Carrier Pkwy., Grand Prairie, TX 75052 | 2018-01-09 |
| 1902312796 | Real Dental Pllc | Dentist | 1215 W. Pioneer Pkwy, Suite 130, Grand Prairie, TX 75052 | 2017-12-16 |
| Find all providers in zip 75052 | ||||
| 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 |
|---|---|---|---|---|
| 1548605835 | Rainbow Children's Clinic 3, P.a. | Pediatrics | 929 W Pioneer Pkwy Ste A, Grand Prairie, TX 75051-4726 | 2013-05-01 |
| 1386841625 | Omolara Abitoye | Pediatrics | 688 W Pioneer Pkwy Ste 120, Grand Prairie, TX 75051 | 2007-06-29 |
| 1295895266 | Toni Capino | Pediatrics | 929 West Pioneer Parkway, Suite A, Grand Prairie, TX 75051-4726 | 2006-12-11 |
| 1598709149 | Ruth Bernardez Tan | Pediatrics | 2985 S State Highway 360, Suite 140, Grand Prairie, TX 75052-7615 | 2006-06-15 |
| 1073508990 | Epifania Miranda Caturay | Pediatrics | 2715 Osler Dr, Grand Prairie, TX 75051-1051 | 2005-09-16 |
| 1669916094 | Shanthi Rajasekaran | Pediatrics | 688 W Pioneer Pkwy, 120, Grand Prairie, TX 75051-4802 | 2016-12-03 |
| 1659626455 | Karla Araujo | Pediatrics | 410 E Pioneer Pkwy, Suite 300, Grand Prairie, TX 75051-4983 | 2012-07-17 |
| 1528334216 | Dallas County Hospital District | Pediatrics | 801 Conover Dr, Grand Prairie, TX 75051-1519 | 2012-03-27 |
| 1972823052 | Triveni Anantharaman Kallur | Pediatrics | 801 Conover Dr, Grand Prairie, TX 75051-1519 | 2010-06-10 |
| 1962734590 | Lina Tan Dy | Pediatrics | 2715 Osler Dr, Grand Prairie, TX 75051-1051 | 2010-02-07 |
| Find all providers in GRAND PRAIRIE | ||||
| City | GRAND PRAIRIE |
| Zip Code | 75052 |
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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.