Greenville Children'S Clinic, P.A.
Pediatrics in Greenville, TX. Organization (NPI-2).
NPI number1265653109
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1265653109
- Entity type
- Organization (NPI-2)
- Legal business name
- Greenville Children'S Clinic, P.A.
- Organization subpart
- No
- Enumeration date
- May 1, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | J2568 | TX | Yes |
Practice location
4211 Joe Ramsey Blvd E Ste 213Greenville, TX 75401-7857
Phone 903-408-7940 · Fax 903-408-7941
Mailing address
4211 Joe Ramsey Blvd E Ste 213Greenville, TX 75401-7857
Phone 903-408-7940 · Fax 903-408-7941
Authorized official
David K Fry
President
9034087940
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