Provider Demographics
NPI:1184745440
Name:COLLIN COUNTY PEDIATRICS, P.A.
Entity type:Organization
Organization Name:COLLIN COUNTY PEDIATRICS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:P
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-733-1758
Mailing Address - Street 1:17070 DALLAS PKWY
Mailing Address - Street 2:SUITE 108
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1950
Mailing Address - Country:US
Mailing Address - Phone:972-733-1758
Mailing Address - Fax:972-733-0311
Practice Address - Street 1:17070 DALLAS PKWY
Practice Address - Street 2:SUITE 108
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1950
Practice Address - Country:US
Practice Address - Phone:972-733-1758
Practice Address - Fax:972-733-0311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8121208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG19817Medicare UPIN