# THE PEDIATRIC CLINIC OF NLR, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THE PEDIATRIC CLINIC OF NLR, P.A.
- **Other names:** The Pediatric Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1669146346
- **Legal business name:** THE PEDIATRIC CLINIC OF NLR, P.A.
- **Authorized official:** TONYA SIMS RN (ADMINISTRATOR)
- **Authorized official phone:** (501) 758-1530

## Contact information

- **Practice address:** 203B PLAZA BLVD, CABOT, AR 72023-3749
- **Practice address phone:** (501) 843-0068
- **Practice address fax:** (501) 843-0696
- **Mailing address:** 1525 COUNTRY CLUB RD, SHERWOOD, AR 72120-5076
- **Mailing address phone:** (501) 758-1530
- **Mailing address fax:** (501) 819-6171

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/05/2021
- **Last updated:** 08/05/2021