Provider Demographics
NPI:1578970307
Name:PEDIATRIC PERIOPERATIVE CONSULTANTS OF N. TX., PLLC
Entity Type:Organization
Organization Name:PEDIATRIC PERIOPERATIVE CONSULTANTS OF N. TX., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:MATSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-566-8340
Mailing Address - Street 1:7777 FOREST LN STE D569
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-6903
Mailing Address - Country:US
Mailing Address - Phone:972-566-8340
Mailing Address - Fax:972-566-8338
Practice Address - Street 1:7777 FOREST LN STE D569
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-6903
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:2014-07-14
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care MedicineGroup - Single Specialty