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Active NPI 1639351505 Organization (Entity Type 2)

Practical Pediatrics

Specialist • Grapevine, TX

About Practical Pediatrics NPI 1639351505 Summary

Practical Pediatrics is a verified healthcare organization specializing in Specialist operating in Grapevine, TX. Located at 811 IRA E WOODS AVE., this facility provides patient care and medical services under National Provider Identifier (NPI) 1639351505.

Administrative operations and authorized compliance are overseen by Michael Mccoy (Owner Pediatrican).

Facility Location & Contact Primary Location

Facility Address

811 Ira E Woods Ave.

Grapevine, TX 760514012

Telephone 8174813585

Fax 8174216529

Authorized Official Information

Authorized Contact Name

DR. Michael Mccoy , M.D.

Title / Role

Owner Pediatrican

Official Telephone

8174813585

Facility Classifications & Specialties

Specialist Primary Taxonomy

NUCC Taxonomy Code: 174400000X

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

6 Historical Events

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NPI Profile Active December 03, 2007

NPI status registered as active in NPPES database

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Updated Practice Location December 03, 2007

Registered at 811 IRA E WOODS AVE., GRAPEVINE, TX 760514012 (Tel: 8174813585)

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Updated Business Mailing Address December 03, 2007

Registered at 811 IRA E WOODS AVE, GRAPEVINE, TX 760518722 (Tel: 8174813585)

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Organization / Clinic Name Updated December 03, 2007

Operating as PRACTICAL PEDIATRICS

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 03, 2007

Specialist (License #H5589 in TX)

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Initial NPI Registration & Enumeration December 03, 2007

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

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NPI Organization Metadata

NPI Number: 1639351505

Entity Type:

Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)

Enumeration Date: December 03, 2007

Last Update: December 03, 2007

Update or Correct Listing

Mailing Address

811 Ira E Woods Ave

Grapevine, TX 760518722

Phone: 8174813585

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.

⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.