GRAPEVINE PEDIATRIC CLINIC, PA
NPI 1710010418
Clinic/Center - Medical Specialty in Grapevine, TX

Q: What is Grapevine Pediatric Clinic, PA's NPI number?

The NPI number for Grapevine Pediatric Clinic, PA is 1710010418. It was assigned to this organization in the NPPES registry on March 13, 2007.

Q: What is Grapevine Pediatric Clinic, PA's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Active since March 13, 2007CLIA 45D0485337 · Waiver

1600 W COLLEGE ST STE 60, GRAPEVINE, TX 76051(817) 488-7334(817) 421-6527 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Grapevine Pediatric Clinic, Pa NPPES

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

GRAPEVINE PEDIATRIC CLINIC, PA (NPI 1710010418) is a healthcare organization registered as a medical specialty in Grapevine, Texas and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through October 4, 2027 and lists Anthony Mark Scott, President, as its authorized official.

NPPES Registry Identity

NPI1710010418

Entity TypeOrganization

Primary Taxonomy261QM2500X

Legal Business NameGRAPEVINE PEDIATRIC CLINIC, PA

Location Address1600 W COLLEGE ST STE 60Grapevine, TX 76051-3580

Mailing Address1600 W College St Ste 60Grapevine, TX 76051-3580 · (817) 488-7334 · Fax (817) 421-6527

Phone(817) 488-7334

Fax(817) 421-6527

Organization SubpartNo

Authorized OfficialAnthony Mark ScottPresident · (817) 488-7334

Enumeration DateMarch 13, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1710010418 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities

Taxonomy Code261QM2500X

Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

1600 W COLLEGE ST STE 60, Grapevine, TX 76051

Open in Google Maps ↗

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D0485337

Grapevine Pediatric Clinic, PA · Grapevine, TX

Active · expires Oct 4, 2027

CLIA Number45D0485337

Laboratory TypePhysician Office

Certificate Effective DateOctober 5, 2025

Certificate Expiration DateOctober 4, 2027

Laboratory DirectorAnthony M. Scott

Laboratory Phone(817) 488-7334

Laboratory LocationGrapevine Pediatric Clinic, PA1600 W College Suite Ll60, Grapevine, TX 76051

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

KATHERINE KOSHY

Pediatrics

1600 W COLLEGE ST STE 60
GRAPEVINE, TX 76051

Tarrant County (817) 488-7334

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 Grapevine Pediatric Clinic, PA's NPI number?

The NPI number for Grapevine Pediatric Clinic, PA is 1710010418. It was assigned to this organization in the NPPES registry on March 13, 2007.

Where is Grapevine Pediatric Clinic, PA located?

Grapevine Pediatric Clinic, PA is located at 1600 W College St Ste 60, Grapevine, TX 76051. The listed phone number is (817) 488-7334.

What is Grapevine Pediatric Clinic, PA's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Does Grapevine Pediatric Clinic, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D0485337) is associated with this NPI, valid through October 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Grapevine Pediatric Clinic, PA was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.