1225830557 NPI number — CLARITY PEDIATRICS MEDICAL GROUP PLLC

Table of content: (NPI 1225830557)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225830557 NPI number — CLARITY PEDIATRICS MEDICAL GROUP PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLARITY PEDIATRICS MEDICAL GROUP PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225830557
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/26/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2261 MARKET ST # 5392
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94114-1612
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-599-0988
Provider Business Mailing Address Fax Number:
866-651-0172

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5601 EXECUTIVE DR STE 500
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRVING
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75038-2729
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-599-0988
Provider Business Practice Location Address Fax Number:
866-651-0173
Provider Enumeration Date:
03/26/2025

Additional Information

Authorized Official

Authorized Official Last Name:
LARRAZABAL MARTINEZ
Authorized Official First Name:
LUIS
Authorized Official Middle Name:
ALESANDRO
Authorized Official Title or Position:
CHIEF MEDICAL OFFICER
Authorized Official Telephone Number:
415-599-0988

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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