NPI age
20 years
Enumerated 2005-11-07
● Active Type 2 · Organization
Pediatric Surgical Associates Of Ft. Worth, P. A.
Pediatric Surgical Associates Of Ft. Worth, P. A. is 1 of 138 surgery organizations in Texas.
Primary specialty
Surgery
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Lockett
Administrator
Last NPPES update
2010-06-17
Source: monthly bulk 2026-05
How this organization compares
Across 138 active surgery providers in Texas.
NPI age
20 years
↑ 2 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2005 → 2026
2005-11Enumerated in NPPES
2005
2026
Where they practice
Primary practice location
901 7th Ave, Suite 210
Fort Worth, TX 761042722
Mailing address
901 7th Ave, Suite 210
Fort Worth, TX 761042722
Authorized official
Debra Lockett
Administrator
📞 8173367881
Individual providers at this organization
20 individual providers on file at this primary practice address.
- Latasha Baker, NP Nurse Practitioner NPI 1922557255
- Mary Banner, MD Psychiatry & Neurology NPI 1508941691
- Tara Bertram, PA-C Physician Assistant NPI 1821368770
- Lisa Buckmiller, MD Otolaryngology NPI 1033120399
- Megan Burson, CPNP-PC Nurse Practitioner NPI 1124629308
- Kia Carter, M.D. Psychiatry & Neurology NPI 1154563179
- Steve Chennankara, D.O Psychiatry & Neurology NPI 1639306608
- Allison Chisholm, M.D Otolaryngology NPI 1295099687
- Kimberly Cox, LCSW Social Worker NPI 1720283989
- Pege Crane, CPNP Nurse Practitioner NPI 1164607370
- Lauren Cunningham, MD Otolaryngology NPI 1861621054
- Brian Dixon, M.D. Psychiatry & Neurology NPI 1831352475
- Whitney Dragon, PMHNP Nurse Practitioner NPI 1164941027
- Amanda Ebner, LPC Counselor NPI 1740565399
- Janine Glassman, LCSW Social Worker NPI 1912246398
- Staci Gottlieb, RN, MSN, PMHNP Nurse Practitioner NPI 1699052555
- Corey Heath Psychologist NPI 1366813453
- Erin Hyken Psychologist NPI 1588083471
- Katherine Jennings, LPC Counselor NPI 1730524265
- Kristen Pyrc, M.D. Psychiatry & Neurology NPI 1760709547
Specialties
-
Surgery PrimaryA surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 112632802 | |
| 05 (TX) | 112632804 | |
| 01 (TX) | 4641193 | AETNA |
Practice context
Multi-provider organization. 20 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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