Provider Demographics
NPI:1033797469
Name:PADILLA MD PLLC
Entity Type:Organization
Organization Name:PADILLA MD PLLC
Other - Org Name:SMILEY MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:PADILLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-729-7817
Mailing Address - Street 1:10260 N CENTRAL EXPY STE 280
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3466
Mailing Address - Country:US
Mailing Address - Phone:469-729-7817
Mailing Address - Fax:469-405-8497
Practice Address - Street 1:10260 N CENTRAL EXPY STE 280
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3466
Practice Address - Country:US
Practice Address - Phone:469-729-7816
Practice Address - Fax:469-405-8497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4230799Medicaid