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General NPI Number Information
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NPI Number | 1568248367
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Entity Type | Organization
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Legal Business Name | TEMPLE PEDIATRICS PLLC
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Dates
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Enumeration Date | 09/06/2023
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 903 CANYON CREEK DR. SUITE 120
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City | TEMPLE
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State | TX
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Zip | 76502-3545
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Country | US
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Telephone | 512-971-2930
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Fax | 512-582-8585
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Provider Business Mailing Address
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Address Line | 903 CANYON CREEK DR. SUITE 120
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City | TEMPLE
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State | TX
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Zip | 76502-3545
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Country | US
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Telephone | 512-971-2930
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Fax | 512-582-8585
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Authorized Official
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Title or Position | OWNER
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Name | SAMANTHA HARMON
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Credential | MSN, CPNP-PC
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Telephone | 512-971-2930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0222X
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Taxonomy Name | Critical Care Pediatric Nurse Practitioner
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License Number |
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License Number State |
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