Organization
PEDIATRIC KARE KLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DELORIS RENEE HARWELL APRN, MSN, CPNP-PC (PEDIATRIC NURSE PRACTITIONER)
(469) 602-5277
Entity
Organization
Contact information
Practice address
104 E US HIGHWAY 80 STE 190, FORNEY, TX 75126-8615
(469) 602-5277
(469) 995-7898
Mailing address
104 E US HIGHWAY 80 STE 190, FORNEY, TX 75126-8615
(469) 602-5277
(469) 995-7898
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
407416301
—
TX
01
—
407416302
TEXAS HEALTH STEPS
TX
Enumeration date
12/17/2018
Last updated
03/12/2020
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