Provider Demographics
NPI:1144798943
Name:NATURAL CHOICE PEDIATRICS, PLLC
Entity Type:Organization
Organization Name:NATURAL CHOICE PEDIATRICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:POTTER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:903-402-5155
Mailing Address - Street 1:3293 ROUND TREE LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4455
Mailing Address - Country:US
Mailing Address - Phone:903-402-5155
Mailing Address - Fax:
Practice Address - Street 1:3535 VICTORY GROUP WAY STE 305
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6722
Practice Address - Country:US
Practice Address - Phone:903-402-5155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-09
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty