MEDICARE: FOREST LANE PEDIATRICS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0070LM	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1225173107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOREST LANE PEDIATRICS

Provider Business Mailing Address
First Line	:	7777 FOREST LN STE B300
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-2510
Country	:	US
Telephone Number	:	972-284-7770
Fax Number	:	972-284-7780

Provider Business Practice Location Address
First Line	:	7777 FOREST LN STE B300
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-2510
Country	:	US
Telephone Number	:	972-284-7770
Fax Number	:	972-284-7780

Authorized Official
Title or Position	:	MANAGER
Name	:	SHIRLEY GROSVENOR
Credential	:
Telephone Number	:	972-284-7776

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	03/29/2017

Similar Medicare Providers

1356396691 — RONALD M BLAIR M.D. P.A.
Practice Location Address:

7777 FOREST LN STE B300
DALLAS, TX
75230-2510

Practice Phone: 972-284-7770
Practice Fax: 972-284-7780

1912049545 — DR. ANN LIU MD
Practice Location Address:

7777 FOREST LN STE B300
DALLAS, TX
75230-2510

Practice Phone: 972-284-7770
Practice Fax: 972-284-7780

1144410556 — DR. DAMIEN HAKEEM MITCHELL M.D.
Practice Location Address:

7777 FOREST LN STE B300
DALLAS, TX
75230-2510

Practice Phone: 972-284-7770
Practice Fax: 972-284-7780

1659643906 — MRS. JANIS M WILBERT IBCLC
Practice Location Address:

7777 FOREST LN STE B300
DALLAS, TX
75230-2510

Practice Phone: 214-549-9312
Practice Fax:

1144462227 — A NEW BEGINNING
Practice Location Address:

2510 ELECTRONIC LN , SUITE 904
DALLAS, TX
75220-1251

Practice Phone: 214-350-1188
Practice Fax: 214-350-0018

1457990491 — DR. JANA RENTZEL PHD, CSD
Practice Location Address:

6705 DELOACHE AVE
DALLAS, TX
75225-2510

Practice Phone: 972-489-9600
Practice Fax:

Directions to “FOREST LANE PEDIATRICS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.