1649377359 NPI number — PEDIATRIX MEDICAL GROUP OF TEXAS BILLING, INC.

Table of content: (NPI 1649377359)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649377359 NPI number — PEDIATRIX MEDICAL GROUP OF TEXAS BILLING, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PEDIATRIX MEDICAL GROUP OF TEXAS BILLING, INC.
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:
1649377359
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1301 CONCORD TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUNRISE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33323-2843
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-384-0175
Provider Business Mailing Address Fax Number:
954-851-1948

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2929 WOODLAND PARK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77082-2687
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-293-7774
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DWYER
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
D
Authorized Official Title or Position:
ASSISTANT SECRETARY
Authorized Official Telephone Number:
954-384-0175

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2080N0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2084A2900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: Z000U99U2 . This is a "MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 00186R . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 137308631 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 137308637 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 141691903 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 141691908 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 141691909 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 529907870 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0084A . This is a "MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0084AZ . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 137308614 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 137308617 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 141691906 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 187119601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 95656049 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0067GW . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 144542104 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 144542105 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 184048701 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0084AZ . This is a "MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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