Organization
JORDAN'S PLACE PEDIATRICS, PA
Active
Other names
Jordan's Place Pediatrics, PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHERRI STONE BARCLAY M.D. (PHYSICAN)
(903) 438-1110
Entity
Organization
Contact information
Practice address
1317 N HILLCREST DR, SULPHUR SPRINGS, TX 75482-2091
(903) 438-1110
(903) 438-1107
Mailing address
1317 N HILLCREST DR, SULPHUR SPRINGS, TX 75482-2091
(903) 438-1110
(903) 438-1107
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
K7145
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0069GW
BCBS GROUP
TX
01
—
1154381259
NPI INDVL
TX
05
—
150000101
—
TX
05
—
150000102
—
TX
01
—
8C0310
BCBS INDVL
TX
Enumeration date
10/24/2007
Last updated
10/24/2007
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