PEDIAQ LLC
NPI 1255885745
Clinic/Center - Primary Care in Austin, TX

Active since August 12, 2016
10413 WALPOLE LN, AUSTIN, TX 78739(310) 713-4847 Get Directions Write a Review

NPPES record last updated: August 12, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pediaq Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEDIAQ LLC (NPI 1255885745) is a healthcare organization registered as a primary care in Austin, Texas and active in the NPI registry since August 2016. The organization lists Fred Johnson, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1255885745
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePEDIAQ LLC
Location Address10413 WALPOLE LNAustin, TX 78739-1553
Mailing Address4849 Greenville Ave Ste 1225Dallas, TX 75206-4130 · (214) 984-3900
Organization SubpartNo
Authorized OfficialFred JohnsonMedical Director · (214) 984-3900
Enumeration DateAugust 12, 2016
NPI 1255885745 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License Licensed in TX · AP81285
10413 WALPOLE LN, Austin, TX 78739

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Pediatrics)
10413 WALPOLE LN
AUSTIN, TX 78739

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pediaq LLC's NPI number?

The NPI number for Pediaq LLC is 1255885745. It was assigned to this organization in the NPPES registry on August 12, 2016.

Where is Pediaq LLC located?

Pediaq LLC is located at 10413 Walpole Ln, Austin, TX 78739. The listed phone number is (310) 713-4847.

What is Pediaq LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Pediaq LLC was last updated on August 12, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.