PEDIATRICS PRIMARY CARE CLINIC (PPCC) (NPI# 1679540280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679540280 |
| Entity Type | Organization |
| Organization Name | PEDIATRICS PRIMARY CARE CLINIC (PPCC) |
| Practice Address |
6303 Harry Hines Blvd Pediatrics Primary Care Clinic (ppcc) Dallas TX 75235-5228 |
| Mailing Address |
Po Box 660599 Dallas TX 75266-0599 |
| Practice Telephone | 2142660100 |
| Mailing Telephone | 2145904105 |
| Mailing Fax Number | 2145904162 |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ERRICA L. BROWN (MEDICAL STAFF COORDINATOR) |
| Authorized Official Telephone | 2145901396 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| X | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6303 HARRY HINES BLVD PEDIATRICS PRIMARY CARE CLINIC (PPCC) |
| City | DALLAS |
| State | TX |
| Zip Code | 75235-5228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750523734 | Saida Khamooshi | Nurse Practitioner | 6303 Harry Hines Blvd, Maple Women's Health Center, Dallas, TX 75235-5270 | 2009-04-06 |
| 1548453889 | Margaret Youngmi Shin | Pharmacist | 6303 Harry Hines Blvd, Suite 200, Dallas, TX 75235-5270 | 2007-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265058895 | Kailey Elaine Flowers | Physical Therapy Assistant | 2400 Empire Central Drive, Suite B, Dallas, TX 75235 | 2020-06-19 |
| 1265061071 | Bella Xinyi O'malley | Student in an Organized Health Care Education/Training Program | 1935 Medical Drive, Dallas, TX 75235 | 2020-04-03 |
| 1427687318 | Can Ozlu | Student in an Organized Health Care Education/Training Program | Children's Medical Center of Dallas, 1935 Medical Distr, Dallas, TX 75235 | 2020-04-03 |
| 1689137515 | Tarek Mansi | Student in an Organized Health Care Education/Training Program | 2222 Medical District Dr Apt 4325, Dallas, TX 75235 | 2019-04-08 |
| 1386117125 | Christine Elizabeth Smith | Physician Assistant | 8134 Tex Oak Avenue, Dallas, TX 75235 | 2019-01-04 |
| 1447720016 | Michelle Angelina Dye | Physician Assistant | 5959 Maple Avenue Apt 1171, Dallas, TX 75235 | 2018-11-27 |
| 1255869335 | Andrea Nicole Pennington-peace | Specialist/Technologist, Other | 1935 Medial District, Dallas, TX 75235 | 2017-06-01 |
| 1194258152 | Tricia Rood | Student in an Organized Health Care Education/Training Program | 5200 Harry Hines Blvd., Dallas, TX 75235 | 2017-04-06 |
| 1437690971 | Robin Lee | Counselor | 8915 Hrry Hines Blvd, Dallas, TX 75235 | 2017-03-16 |
| 1871033746 | Javier Davila-lopez | Counselor | 1545 Mockingbird Lane, Suite 4000, Dallas, TX 75235 | 2017-02-27 |
| Find all providers in zip 75235 | ||||
| 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 |
|---|---|---|---|---|
| 1982131363 | Julia C Durante | Pediatrics | 2350 N Stemmons Fwy Ste F5200, Dallas, TX 75207-2700 | 2017-05-17 |
| 1891235206 | Jill Whitehurst | Pediatrics | 6436 Glendora Ave, Dallas, TX 75230-5125 | 2017-03-03 |
| 1407210982 | Rohan Venugopal Menon | Pediatrics | 7777 Forest Lane, Bldg B 300, Dallas, TX 75230 | 2016-04-11 |
| 1144686601 | Souren Chakmakjian | Pediatrics | 3855 Branchfield Dr, Dallas, TX 75214-2949 | 2016-01-13 |
| 1851756977 | Aaron L. Kreisler, M.d. P.a. | Pediatrics | 1151 N Buckner Blvd # Pb1, Suite 203, Dallas, TX 75218-3426 | 2015-12-16 |
| 1679982540 | Mevelline Lim | Pediatrics | 2350 N Stemmons Fwy Ste 2400, Dallas, TX 75207-2700 | 2014-08-05 |
| 1134549983 | Diana Liz Arriola | Pediatrics | 3434 W Illinois Ave Ste 306-3, Dallas, TX 75211-8709 | 2014-04-20 |
| 1386064269 | Jennifer Nguyen Chew | Pediatrics | 6300 Harry Hines Blvd Ste 101, Dallas, TX 75235-5259 | 2014-04-18 |
| 1215379987 | Colleen D Edge | Pediatrics | 8355 Walnut Hill Ln Ste 105, Dallas, TX 75231-4242 | 2013-07-23 |
| 1083055214 | Richard William Markus | Pediatrics | 7777 Forest Ln Ste B320, Dallas, TX 75230-6820 | 2013-07-16 |
| Find all providers in DALLAS | ||||
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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.