Organization
LITTLE PLUM BLOSSOM PEDIATRICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA FOWLER D.O. (MANAGING MEMBER)
(817) 441-2266
Entity
Organization
Contact information
Practice address
311 S FM 1187, 300, ALEDO, TX 76008-6449
(817) 441-2266
(877) 293-3512
Mailing address
311 S FM 1187, 300, ALEDO, TX 76008-6449
(817) 441-2266
(877) 293-3512
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
M9285
TX
Other
Enumeration date
06/26/2013
Last updated
06/26/2013
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