Provider Demographics
NPI:1053615625
Name:PHYSICIANS FOR CHILDREN
Entity type:Organization
Organization Name:PHYSICIANS FOR CHILDREN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-456-6715
Mailing Address - Street 1:PO BOX 844582
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4582
Mailing Address - Country:US
Mailing Address - Phone:214-456-4550
Mailing Address - Fax:214-456-4490
Practice Address - Street 1:2350 N STEMMONS FWY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75207-2700
Practice Address - Country:US
Practice Address - Phone:469-488-7100
Practice Address - Fax:469-488-7101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-22
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX315041907Medicaid
TX323239904Medicaid
TX200950804Medicaid
TX316617501Medicaid
TX296409004Medicaid
TX312059404Medicaid
TX200950807Medicaid
TX284289001Medicaid
TX311619604Medicaid
TX312874604Medicaid
TX324083001Medicaid
TX333431001Medicaid
TX214745601Medicaid
TX312162604Medicaid
TX216913801Medicaid
TX283321201Medicaid