Organization
COWTOWN PEDIATRIX CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUE KHAMMAR (PRESIDENT/MANAGER)
(871) 386-5500
Entity
Organization
Contact information
Practice address
4011 BENBROOK HWY STE C, FORT WORTH, TX 76116-7800
(817) 386-5500
(817) 386-5500
Mailing address
4011 BENBROOK HWY STE C, FORT WORTH, TX 76116-7800
(817) 386-5500
(817) 386-5500
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
02/09/2015
Last updated
04/08/2021
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