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NPI Code Detail

MEDICARE: 1ST CHOICE PEDIATRICS

MEDICARE: 1ST CHOICE PEDIATRICS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianK1253TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497179147
Entity Type Code : Organization
Provider Name (Legal Business Name) : 1ST CHOICE PEDIATRICS
Provider Business Mailing Address
First Line : 1205 N 6TH ST
Second Line :
City : LONGVIEW
State : TX
Zip : 75601-5539
Country : US
Telephone Number : 903-230-0235
Fax Number : 903-230-0242
Provider Business Practice Location Address
First Line : 1205 N 6TH ST
Second Line :
City : LONGVIEW
State : TX
Zip : 75601-5539
Country : US
Telephone Number : 903-230-0235
Fax Number : 903-230-0242
Authorized Official
Title or Position : CEO
Name : DR. KATHLEEN MCCRORY
Credential : DO
Telephone Number : 903-230-0235
Provider Enumeration Date : 02/14/2014
Last Update Date : 02/14/2014

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Directions to “1ST CHOICE PEDIATRICS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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