PEDIAQ
NPI 1477938132
Nurse Practitioner - Pediatrics in Dallas, TX

Active since July 23, 2015
17101 PRESTON RD, STE 115, DALLAS, TX 75248(214) 984-3900(972) 294-3343 Get Directions Write a Review

NPPES record last updated: July 23, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Pediaq NPPES

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

PEDIAQ (NPI 1477938132) is a healthcare organization registered as a pediatrics in Dallas, Texas and active in the NPI registry since July 2015. The organization lists Frederick Johnson, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1477938132
Entity TypeOrganization
Primary Taxonomy363LP0200X
Legal Business NamePEDIAQ
Location Address17101 PRESTON RD, STE 115Dallas, TX 75248-1331
Mailing Address17101 Preston Rd, Ste 115Dallas, TX 75248-1331 · (214) 984-3900 · Fax (972) 294-3343
Fax(972) 294-3343
Organization SubpartNo
Authorized OfficialFrederick JohnsonMedical Director · (214) 984-3900
Enumeration DateJuly 23, 2015
NPI 1477938132 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
17101 PRESTON RD, Dallas, TX 75248

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 10

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

Obstetrics & Gynecology (Gynecology)
17101 PRESTON RD, SUITE 200
DALLAS, TX 75248
Family Medicine
17101 PRESTON RD, SUITE 200
DALLAS, TX 75248
Obstetrics & Gynecology
17101 PRESTON RD, SUITE 200
DALLAS, TX 75248
Family Medicine
17101 PRESTON RD, SUITE 200
DALLAS, TX 75248
Nurse Practitioner (Pediatrics)
17101 PRESTON RD, STE 115
DALLAS, TX 75248
Counselor (Professional)
17101 PRESTON RD
DALLAS, TX 75248
Counselor (Professional)
17101 PRESTON RD
DALLAS, TX 75248
Family Medicine
17101 PRESTON RD, SUITE 200
DALLAS, TX 75248

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's NPI number?

The NPI number for Pediaq is 1477938132. It was assigned to this organization in the NPPES registry on July 23, 2015.

Where is Pediaq located?

Pediaq is located at 17101 Preston Rd Ste 115, Dallas, TX 75248. The listed phone number is (214) 984-3900.

What is Pediaq's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

When was this NPI record last updated?

The NPPES record for Pediaq was last updated on July 23, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.