Organization
TEXAS NEWBORN SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL D DWYER (ASSISTANT SECRETARY)
(954) 384-0175
Entity
Organization
Contact information
Practice address
3001 E PRESIDENT GEORGE BUSH HWY, SUITE 250, RICHARDSON, TX 75082-3542
(972) 437-5099
(972) 764-1661
Mailing address
1301 CONCORD TERRACE, SUNRISE, FL 33323-2843
(954) 384-0175
(954) 851-1948
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005
TRICARE
TX
01
—
0006
TRICARE
TX
01
—
00413Y
MEDICARE
TX
01
—
0067GW
BCBS
TX
01
—
00X507
MEDICARE
TX
01
—
00X508
MEDICARE
TX
01
—
00X509
MEDICARE
TX
05
—
183525801
—
TX
05
—
183525802
—
TX
05
—
183525803
—
TX
05
—
186765701
—
TX
05
—
186853101
—
TX
05
—
200052430A
—
TX
01
—
5539639
AETNA
TX
Enumeration date
07/27/2006
Last updated
12/20/2019
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