MAYNARD C DYSON


Address: 1500 Cooper St, Fort Worth, TX 76104-2710
Phone: 6828856299

MAYNARD C DYSON (NPI# 1619988763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1619988763
Entity Type Individual
Full Name MAYNARD C DYSON
Credential MD
Practice Address 1500 Cooper St
Fort Worth
TX 76104-2710
Mailing Address Po Box 99371
Fort Worth
TX 76199-0371
Practice Telephone 6828856299
Practice Fax Number 6828851090
Mailing Telephone 6828851855
Mailing Fax Number 6828857347
Enumeration Date 2006-08-11
Last Update Date 2012-04-03
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2080P0214X Pediatrics
Specialization: Pediatric Pulmonology
H9069 TX Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
TX CSHCN 136186715 01
TX FIRSTCARE PIN 112070100 01
TX CSHCN 136186713 01
TX MULTIPLAN PIN 62741133 01
TX AMERIGROUP PIN 10028696 01
TX BCBSTX GRP PIN 00U87Z 01
TX 136186714 05
TX UHC PIN 1392667 01
TX CIGNA PIN 1485631 01
TX BCBSTX IND PIN 89V243 01
TX GREAT WEST PIN 386710 01
TX AETNA PIN 4613484 01
TX 136186712 05
TX 140442845 05
TX FIRSTHEALTH PIN 1640370 01
TX PHCS PIN 413449 01
TX SUPERIOR PIN 109539 01

Office Location

Street Address 1500 COOPER ST
City FORT WORTH
State TX
Zip Code 76104-2710

Providers in the same location

NPI Name Taxonomy Address Enumeration
1497747653 Luciana Rochetti Physician Assistant 1500 Cooper St, Fort Worth, TX 76104-2710 2005-08-15
1821696493 Leekelli Kennedy Dietitian, Registered 1500 Cooper St, Fort Worth, TX 76104-2710 2020-10-15
1871109124 Caitlyn R Praytor Nurse Practitioner 1500 Cooper St, Fort Worth, TX 76104-2710 2020-09-22
1497389126 Chelsea Barrow Dietitian, Registered 1500 Cooper St, Fort Worth, TX 76104-2710 2020-03-03
1386281871 Emily Susan Larkin Nurse Practitioner 1500 Cooper St, Fort Worth, TX 76104-2710 2019-12-04
1508416629 Christa Standefer Family Medicine 1500 Cooper St, Fort Worth, TX 76104-2710 2019-09-19
1972153112 Alexis Courtney Dietitian, Registered 1500 Cooper St, Fort Worth, TX 76104-2710 2019-09-19
1366099376 Haley Tullos Dietitian, Registered 1500 Cooper St, Fort Worth, TX 76104-2710 2019-08-23
1538716139 Amanda Rae Macdonald Dietitian, Registered 1500 Cooper St, Fort Worth, TX 76104-2710 2019-08-20
1730731498 Erin Walkley Dietitian, Registered 1500 Cooper St, Fort Worth, TX 76104-2710 2019-07-12
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1669082186 Cvs Pharmacy, Inc. Durable Medical Equipment & Medical Supplies 1115 8th St, Fort Worth, TX 76104 2020-08-10
1992343693 Iris Giove Psychologist John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 2019-12-13
1104480656 Swarnalaxmi Umapathy Student in an Organized Health Care Education/Training Program 900 8th Avenue, Fort Worth, TX 76104 2019-04-30
1881189132 Mega Surgical Assistants LLC Specialist/Technologist, Other 1301pennsylvania, Fort Worth, TX 76104 2018-06-28
1356848899 Tricia Kelly Nurse Practitioner 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 2018-04-11
1952820979 Modern Vein Clinic Internal Medicine 757 8th Avenue, Suite A, Forth Worth, TX 76104 2017-09-11
1790207165 Vanessa Abbood Dietitian, Registered 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 2017-07-07
1922537562 Nicole Marie Tod Student in an Organized Health Care Education/Training Program 1500 S Main Street, Fort Worth, TX 76104 2017-06-07
1770025934 Micah Bonola Chiropractor 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 2016-11-04
1518315894 United Bioscience, LLC. Clinical Medical Laboratory 901 W. Leuda St., B, Fort Worth, TX 76104 2016-05-27
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Taxonomy Information

Taxonomy Code 2080P0214X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Pediatric Pulmonology

Taxonomy Definition

A pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques.
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/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1699132381 Stephen's Pedi & Pulmonary Practice, Pa Pediatrics 900 Jerome St, 102, Fort Worth, TX 76104-3945 2016-01-26
1174739619 Anunya Hiranrattana Pediatrics 1500 Cooper St, Floor 2, Fort Worth, TX 76104-2710 2007-05-14
1063506913 Karen D Schultz Pediatrics 1500 Cooper St, Fort Worth, TX 76104-2710 2006-10-03
1053404137 Sami K W Hadeed Pediatrics 1500 Cooper St, Fort Worth, TX 76104-2710 2006-10-02
1326144486 John K Pfaff Pediatrics 1500 Cooper St, Fort Worth, TX 76104-2710 2006-09-16
1184739534 Nancy N Dambro Pediatrics 1500 Cooper St, Fort Worth, TX 76104-2710 2006-08-19
1023029204 James C Cunningham Pediatrics 1500 Cooper St, Fort Worth, TX 76104-2710 2006-08-11

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1891085528 Sonal Malhotra Pediatrics 7700 Fannin St Ste 1040, Houston, TX 77054 2011-04-14
1669792248 Joseph Tayar Pediatrics 11111 Research Blvd Ste 300, Austin, TX 78759-5792 2010-06-07
1003143553 Marlene D. Typaldos Sanchez Pediatrics 6701 Fannin St Ste 1040, Houston, TX 77030-2611 2009-11-04
1508031956 Arthur C Ogborn Jr. Pediatrics 844 Central Blvd Ste 420, Brownsville, TX 78520-7535 2008-04-28
1417125154 Texas Pediatric Pulmonary Consultants, P.a. Pediatrics 140 W Lamberth Rd, Suite C, Sherman, TX 75092-2667 2008-02-15
1073702981 Austin Children's Chest Associates II Pediatrics 3305 Northland Dr Ste 512, Austin, TX 78731-4991 2007-10-16
1083807820 Kavita A Patel Pediatrics 8611 N Mopac Expy Ste 300, Austin, TX 78759-8319 2007-08-24
1144309279 Harold J. Farber Pediatrics 6701 Fannin St, 9th Floor, Mc Cc 920.01, Texas Children's Hospital Clinical Care Center, Houston, TX 77030 2006-11-02
1710062237 Roberto A Ayres Mdpa Pediatrics 1900 South Jackson, Ste 7, Mcallen, TX 78501 2006-10-25
1083721377 Lee Kirchner Pediatrics 3619 Paesanos Parkway, Suite 212, San Antonio, TX 78231-1255 2006-08-24
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Competitor

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City FORT WORTH
Zip Code 76104

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Dataset Information

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.

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