Forever Kids Pediatric Clinic

NPI #1326435199 in Canton, Texas

Provider Information

NPI Number
1326435199
Entity Type
Organization
Organization Name
Forever Kids Pediatric Clinic
Primary Specialty
Clinic/Center
Enumeration Date
Apr 20, 2015
Last Updated
Jan 26, 2023

Practice Location

Address
20783 INTERSTATE 20 SOUTH ACCESS ROAD
City
Canton
State
Texas
ZIP Code
75103
Phone
(214) 773-5669

Authorized Official

Name
MRS. LACY DAWN BURKES, RN , CPNP-PC
Title
PEDIATRIC NURSE PRACTITIONER
Phone
(214) 773-5669

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Primary CarePrimary Care
Clinic/Center

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