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Organization
PLANO CHILDREN'S MEDICAL CLINIC
Active
Organization
PLANO CHILDREN'S MEDICAL CLINIC
Active
Parent organization
PLANO CHILDREN'S MEDICAL CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PLANO CHILDREN'S MEDICAL CLINIC
Authorized official
SUSAN SHULER (EXECUTIVE DIRECTOR)
(972) 801-9689
Entity
Organization
Contact information
Practice address
303 S HIGHWAY 78, SUITE 106, WYLIE, TX 75098-3944
(972) 801-9689
(972) 801-9015
Mailing address
PO BOX 940109, PLANO, TX 75094-0109
(972) 801-9689
(972) 801-9015
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
083030901
—
TX
05
—
083030902
—
TX
Enumeration date
02/28/2011
Last updated
02/28/2011
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