Provider Demographics
NPI:1841415999
Name:PEDIATRIC ASSOCIATES OF NORTH TEXAS
Entity Type:Organization
Organization Name:PEDIATRIC ASSOCIATES OF NORTH TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D. - PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERROD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-596-8100
Mailing Address - Street 1:3721 W 15TH ST
Mailing Address - Street 2:SUITE 601
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7755
Mailing Address - Country:US
Mailing Address - Phone:972-596-8100
Mailing Address - Fax:972-867-3658
Practice Address - Street 1:3721 W 15TH ST
Practice Address - Street 2:SUITE 601
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7755
Practice Address - Country:US
Practice Address - Phone:972-596-8100
Practice Address - Fax:972-867-3658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE80342Medicare UPIN
TXE77647Medicare UPIN