NPI age
9 years
Enumerated 2016-08-12
● Active Type 2 · Organization
Pediaq Llc
Pediaq Llc is 1 of 1466 clinic/center organizations in Texas.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Johnson
Medical Director
Last NPPES update
2016-08-12
Source: monthly bulk 2026-05
How this organization compares
Across 1466 active clinic/center providers in Texas.
NPI age
9 years
≈ at median (9 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2016 → 2026
2016-08Enumerated in NPPES
2016
2026
Where they practice
Primary practice location
10413 Walpole Ln
Austin, TX 787391553
Mailing address
4849 Greenville Ave Ste 1225
Dallas, TX 752064130
Authorized official
Fred Johnson, DO
Medical Director
📞 2149843900
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Chanin McClurkin, APRN Nurse Practitioner NPI 1679029045
Specialties
-
Clinic/Center PrimaryDefinition to come...
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.