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General NPI Number Information
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NPI Number | 1083158141
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Entity Type | Organization
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Legal Business Name | PLANO BIRTH PLACE
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Dates
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Enumeration Date | 12/08/2016
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Last Update Date | 12/08/2016
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Provider Practice Location Address
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Address Line | 5172 VILLAGE CREEK DR STE 101
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City | PLANO
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State | TX
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Zip | 75093-4444
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Country | US
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Telephone | 469-912-0727
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Fax |
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Provider Business Mailing Address
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Address Line | 5172 VILLAGE CREEK DR STE 101
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City | PLANO
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State | TX
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Zip | 75093-4444
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Country | US
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Telephone | 469-912-0727
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Fax |
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Authorized Official
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Title or Position | OWNER/CERTIFIED NURSE MIDWIFE
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Name | JEANNINE WATSON TATE,
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Credential | MSN, RN, CNM
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Telephone | 469-912-0727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number |
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License Number State |
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