Provider Demographics
NPI:1083443949
Name:JORDAN'S PLACE PEDIATRICS, PA
Entity type:Organization
Organization Name:JORDAN'S PLACE PEDIATRICS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:STONE
Authorized Official - Last Name:BARCLAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-438-1110
Mailing Address - Street 1:984 N TEXAS ST
Mailing Address - Street 2:
Mailing Address - City:EMORY
Mailing Address - State:TX
Mailing Address - Zip Code:75440-2413
Mailing Address - Country:US
Mailing Address - Phone:903-494-0947
Mailing Address - Fax:903-494-4252
Practice Address - Street 1:984 N TEXAS ST
Practice Address - Street 2:
Practice Address - City:EMORY
Practice Address - State:TX
Practice Address - Zip Code:75440-2413
Practice Address - Country:US
Practice Address - Phone:903-494-0947
Practice Address - Fax:903-494-4252
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JORDAN'S PLACE PEDIATRICS, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty