The Pediatric Clinic

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

THE PEDIATRIC CLINIC

Practice address

4818 Wellington St
Suite 1
Greenville, TX 75402-6010

Phone

(903) 455-3261

Fax

(903) 455-0211

NPI assigned

Sep 15, 2006

Organization subpart

No

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

Authorized official

Name

Connie R. Giles

Title

Office Manager

Phone

(903) 455-3261

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780780254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4818 WELLINGTON ST",
            "address_2": "SUITE 1",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754026010",
            "telephone_number": "903-455-3261",
            "fax_number": "903-455-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4818 WELLINGTON ST",
            "address_2": "SUITE 1",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754026010",
            "telephone_number": "903-455-3261",
            "fax_number": "903-455-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PEDIATRIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GILES",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "903-455-3261"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "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.