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General NPI Number Information
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NPI Number | 1790103869
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Entity Type | Organization
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Legal Business Name | DELL CHILDREN'S MEDICAL GROUP
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Dates
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Enumeration Date | 04/04/2014
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 1000 HESTERS CROSSING RD
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City | ROUND ROCK
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State | TX
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Zip | 78681-8020
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Country | US
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Telephone | 512-628-1800
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Fax | 512-628-1801
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Provider Business Mailing Address
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Address Line | 1301 BARBARA JORDAN BLVD SUITE 200
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City | AUSTIN
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State | TX
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Zip | 78723-3077
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Country | US
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Telephone | 512-628-1800
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Fax | 512-628-1801
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Authorized Official
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Title or Position | VP/COO
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Name | CLAYTON CARSNER
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Credential |
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Telephone | 512-324-5846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207NP0225X
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Taxonomy Name | Pediatric Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2080H0002X
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Taxonomy Name | Pediatric Hospice and Palliative Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2080P0201X
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Taxonomy Name | Pediatric Allergy/Immunology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 2080P0210X
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Taxonomy Name | Pediatric Nephrology Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 2080P0216X
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Taxonomy Name | Pediatric Rheumatology Physician
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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