Organization
MALCOLM X PEDIATRIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUTH GREER FNP (OWNER)
(214) 428-2010
Entity
Organization
Contact information
Practice address
4432 MALCOLM X BLVD, DALLAS, TX 75215-4349
(214) 428-2010
(214) 428-2065
Mailing address
4432 MALCOLM X BLVD, DALLAS, TX 75215-4349
(214) 428-2010
(214) 428-2065
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
245458
TX
363LF0000X
Family Nurse Practitioner
245458
TX
363LP0200X
Pediatric Nurse Practitioner
245458
TX
Other
Enumeration date
09/10/2009
Last updated
09/10/2009
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