Provider Demographics
NPI:1346247889
Name:PEDIATRIC ACUTE CARE ASSOCIATES OF NORTH TEXAS, PLLC
Entity Type:Organization
Organization Name:PEDIATRIC ACUTE CARE ASSOCIATES OF NORTH TEXAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:C
Authorized Official - Last Name:PAPO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-566-8340
Mailing Address - Street 1:7777 FOREST LN
Mailing Address - Street 2:D569
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2571
Mailing Address - Country:US
Mailing Address - Phone:972-566-8340
Mailing Address - Fax:972-566-8338
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:STE D569
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-6894
Practice Address - Country:US
Practice Address - Phone:972-566-8340
Practice Address - Fax:972-566-8338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX822626032080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00370ROtherBCBS
TX142428504Medicaid
OK100755390AMedicaid
TX142428501Medicaid
TX00370RMedicare PIN