OrganizationActive
Grand Prairie Pediatric and Allergy Clinic Inc
NPI 1952368664 · Pediatrics Physician · Oklahoma City, OK
Provider details
- NPI number
- 1952368664
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kenneth Jackson, Pres(405) 721-8090
- License
- 11030 (OK)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
7301 N Comanche Ave
Oklahoma City, OK 73132
Phone: (405) 721-8090
Fax: (405) 722-8529
Street-level locationGet directions
Mailing address
7301 N Comanche Ave
Oklahoma City, OK 73132
Registry dates
- Enumerated
- 2006-04-27
- Last updated
- 2012-05-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.