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NPI Code Detail

MEDICARE: PEDIATRIX MEDICAL GROUP OF TEXAS BILLING, INC.

MEDICARE: PEDIATRIX MEDICAL GROUP OF TEXAS BILLING, INC.
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
12080N0001XNeonatal-Perinatal Medicine Physician

General Provider Information

NPI Number : 1487490991
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEDIATRIX MEDICAL GROUP OF TEXAS BILLING, INC.
Provider Business Mailing Address
First Line : PO BOX 840532
Second Line :
City : DALLAS
State : TX
Zip : 75284-0532
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9525 GREENVILLE AVE
Second Line :
City : DALLAS
State : TX
Zip : 75243-4116
Country : US
Telephone Number : 281-409-6011
Fax Number :
Authorized Official
Title or Position : OFFICER
Name : MICHAEL D. DWYER
Credential : MD
Telephone Number : 800-243-3839
Provider Enumeration Date : 07/03/2024
Last Update Date : 07/03/2024

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