Pediadults (pediatrics & Adults) After Hours Clinic | |
1350 Northwest Hwy Ste 105 Garland TX 75041-5844 | |
(972) 896-9501 | |
(469) 899-1275 |
Full Name | Pediadults (pediatrics & Adults) After Hours Clinic |
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Speciality | Family Medicine |
Location | 1350 Northwest Hwy Ste 105, Garland, Texas |
Authorized Official Name and Position | Jacqueline Davis (RN) |
Authorized Official Contact | 9728969501 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Pediadults (pediatrics & Adults) After Hours Clinic 1350 Northwest Hwy Ste 105 Garland TX 75041-5844 Ph: (972) 896-9501 | Pediadults (pediatrics & Adults) After Hours Clinic 1350 Northwest Hwy Ste 105 Garland TX 75041-5844 Ph: (972) 896-9501 |
NPI Number | 1568982304 |
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Provider Enumeration Date | 06/22/2017 |
Last Update Date | 09/06/2022 |
Medicare PECOS PAC ID | 8729351606 |
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Medicare Enrollment ID | O20170829003601 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568982304 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | AP124137 (Texas) | Primary |
Provider Name | Jacqueline L Davis |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1801220488 PECOS PAC ID: 8628382280 Enrollment ID: I20150826001341 |
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