Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kidsville Pediatrics Southlake PLLC

Organization Pediatrics Physician · NPI 1598639635

Kidsville Pediatrics Southlake PLLC is a Pediatrics Physician in Southlake, Texas. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
6
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2813 W Southlake Blvd Ste 100
Southlake, TX 76092-6832
Phone: (682) 345-8010
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Critical Care Medicine Physician (primary) Taxonomy 2080P0203X
Pediatrics Physician Taxonomy 208000000X
Pulmonary Function Technologist Certified Respiratory Therapist Taxonomy 2278P1006X
Physician Assistant Taxonomy 363A00000X
Pediatric Nurse Practitioner Taxonomy 363LP0200X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1598639635
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ali Shah — Executive Manager · (682) 345-8010
NPI enumeratedOctober 1, 2025
Last updated in NPPESOctober 2, 2025
Certification dateOctober 2, 2025
Mailing address2813 W Southlake Blvd Ste 100, Southlake, TX 76092-6832

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