Provider Demographics
NPI:1023117900
Name:PEDIATRIC SPECIALISTS OF PLANO
Entity type:Organization
Organization Name:PEDIATRIC SPECIALISTS OF PLANO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:BYARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-473-7777
Mailing Address - Street 1:3405 MIDWAY RD
Mailing Address - Street 2:SUITE 650
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8138
Mailing Address - Country:US
Mailing Address - Phone:972-473-7777
Mailing Address - Fax:972-473-7780
Practice Address - Street 1:3405 MIDWAY RD
Practice Address - Street 2:SUITE 650
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8138
Practice Address - Country:US
Practice Address - Phone:972-473-7777
Practice Address - Fax:972-473-7780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
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
TX=========OtherTAX ID