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

Pediaq

Organization Pediatric Nurse Practitioner · NPI 1477938132

Pediaq is a Pediatric Nurse Practitioner in Dallas, Texas. Registered with an NPI since 2015.

In the registry since
2015

Practice location Address checks out

17101 Preston Rd Ste 115
Dallas, TX 75248-1331
Phone: (214) 984-3900
Fax: (972) 294-3343
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X

Record details

NPI number1477938132
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Frederick Johnson — Medical Director · (214) 984-3900
NPI enumeratedJuly 23, 2015
Last updated in NPPESJuly 23, 2015
Mailing address17101 Preston Rd, Ste 115, Dallas, TX 75248-1331

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