Provider Demographics
NPI:1326062944
Name:TEXAS NEWBORN SERVICES, INC.
Entity Type:Organization
Organization Name:TEXAS NEWBORN SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:DWYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-384-0175
Mailing Address - Street 1:1301 CONCORD TERRACE
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2843
Mailing Address - Country:US
Mailing Address - Phone:954-384-0175
Mailing Address - Fax:954-851-1948
Practice Address - Street 1:3001 E PRESIDENT GEORGE BUSH HWY
Practice Address - Street 2:SUITE 250
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-3542
Practice Address - Country:US
Practice Address - Phone:972-437-5099
Practice Address - Fax:972-764-1661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00X509OtherMEDICARE
TX0005OtherTRICARE
TX00X507OtherMEDICARE
TX186853101Medicaid
TX0067GWOtherBCBS
TX200052430AMedicaid
TX0006OtherTRICARE
TX00X508OtherMEDICARE
TX183525803Medicaid
TX00413YOtherMEDICARE
TX183525801Medicaid
TX183525802Medicaid
TX186765701Medicaid
TX5539639OtherAETNA