Organization
PLANO CHILDREN'S MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN SHULER (EXECUTIVE DIRECTOR)
(972) 801-9689
Entity
Organization
Contact information
Practice address
1407 14TH ST, PLANO, TX 75074-6301
(972) 801-9689
(972) 801-9015
Mailing address
1407 14TH ST, PLANO, TX 75074-6301
(972) 801-9689
(972) 801-9015
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9832
—
TX
Enumeration date
09/29/2006
Last updated
08/22/2020
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