| Plano Children's Medical Clinic | |
|
1407 14th St Plano TX 75074-6301 | |
| (972) 801-9689 | |
| (972) 801-9015 |
| Full Name | Plano Children's Medical Clinic |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1407 14th St, Plano, Texas |
| Authorized Official Name and Position | Susan Shuler (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9728019689 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Plano Children's Medical Clinic 1407 14th St Plano TX 75074-6301 Ph: (972) 801-9689 | Plano Children's Medical Clinic 1407 14th St Plano TX 75074-6301 Ph: (972) 801-9689 |
| NPI Number | 1457443095 |
|---|---|
| Provider Enumeration Date | 09/29/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457443095 | NPI | - | NPPES |
| 9832 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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