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General NPI Number Information
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NPI Number | 1659877975
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Entity Type | Organization
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Legal Business Name | GROWING TREE PEDIATRICS, PLLC
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Dates
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Enumeration Date | 04/04/2018
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Last Update Date | 04/12/2018
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Provider Practice Location Address
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Address Line | 1102 RANCH RD STE 107
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City | FORNEY
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State | TX
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Zip | 75126-4796
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Country | US
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Telephone | 972-552-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 W 15TH ST APT 401
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City | MOUNT PLEASANT
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State | TX
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Zip | 75455-2867
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Country | US
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Telephone | 214-908-2554
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTOPHER EDWARD MILLER
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Credential | DO
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Telephone | 214-908-2554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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