| NPI | 1124721410 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2023-03-24 |
| Last Updated | 2023-03-24 |
| Authorized Official | Samantha Roworth-Chaikin Physician Owner Phone: 9033153966 |
| Mailing Address | 703 E Marshall Ave Ste 4002 Longview, TX 75601-5622 United States Phone: (903) 315-3966 | Fax: (903) 230-0795 📍 View Map |
| Primary Practice Address | 703 E Marshall Ave Ste 4002 Longview, TX 75601-5622 United States Phone: (903) 315-3966 | Fax: (903) 230-0795 📍 View Map |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 363L00000X – Nurse Practitioner | — | — |
| Yes | 208000000X – Pediatrics | — | — |
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About NPI 1124721410
Premiere Pediatrics Pllc is an organization registered in the CMS NPPES NPI Registry with NPI number 1124721410. The primary specialty listed is Pediatrics. The organization is located in Longview, TX. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2023-03-24. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1124721410?
NPI 1124721410 belongs to Premiere Pediatrics Pllc, a Pediatrics in Longview, TX. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1124721410 active?
The current status of NPI 1124721410 in the NPPES registry is Active. The record was last updated on 2023-03-24.
What specialty is NPI 1124721410?
NPI 1124721410 is classified under the taxonomy Pediatrics. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1124721410?
You can verify NPI 1124721410 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1124721410?
The primary practice address on file for NPI 1124721410 is 703 E Marshall Ave Ste 4002, Longview, TX 75601-5622. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1124721410 issued?
NPI 1124721410 was first issued (enumerated) on 2023-03-24. The NPPES record was last updated on 2023-03-24.
Practice Location Map
Premiere Pediatrics Pllc is located at 703 E Marshall Ave Ste 4002, Longview, TX. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Premiere Pediatrics Pllc. All records sourced from the CMS NPPES registry.