Greenville Children'S Clinic, P.a.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

J2568 Issued in TX

Legal business name

GREENVILLE CHILDREN'S CLINIC, P.A.

Practice address

4211 Joe Ramsey Blvd E Ste 213
Greenville, TX 75401-7857

Phone

(903) 408-7940

Fax

(903) 408-7941

NPI assigned

May 1, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David K Fry, M.D.

Title

President

Phone

(903) 408-7940

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265653109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 JOE RAMSEY BLVD E STE 213",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754017857",
            "telephone_number": "903-408-7940",
            "fax_number": "903-408-7941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 JOE RAMSEY BLVD E STE 213",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754017857",
            "telephone_number": "903-408-7940",
            "fax_number": "903-408-7941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE CHILDREN'S CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FRY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-408-7940",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J2568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Greenville, TX
• Providers in Greenville, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.