Provider Demographics
NPI:1336572692
Name:HOPE PEDIATRICS LLC
Entity Type:Organization
Organization Name:HOPE PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:903-714-7422
Mailing Address - Street 1:1420 W MOCKINGBIRD LN STE 500
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-6971
Mailing Address - Country:US
Mailing Address - Phone:214-396-4673
Mailing Address - Fax:214-396-4678
Practice Address - Street 1:1420 W MOCKINGBIRD LN STE 500
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-6971
Practice Address - Country:US
Practice Address - Phone:214-396-4673
Practice Address - Fax:214-396-4678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-09
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
TX015840251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3256398-01Medicaid