Provider Demographics
NPI:1902885809
Name:PID ASSOCIATES, P.A.
Entity type:Organization
Organization Name:PID ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:WILLILAM
Authorized Official - Last Name:EHRETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-855-8510
Mailing Address - Street 1:4014 CRESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-1645
Mailing Address - Country:US
Mailing Address - Phone:214-340-3513
Mailing Address - Fax:
Practice Address - Street 1:4014 CRESTWOOD DR
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-1645
Practice Address - Country:US
Practice Address - Phone:214-855-8510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious DiseasesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100755250AMedicaid
TX121888502Medicaid
TX00610KOtherBCBS