Kid Potential, Inc.

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

KID POTENTIAL, INC.

Practice address

2912 W Davis St
Suite 140
Conroe, TX 77304-2041

Phone

(936) 539-4574

Fax

(936) 539-4585

NPI assigned

Jan 4, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Judy Faulkner

Title

Chief Financial Officer

Phone

(936) 539-4574

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124175237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2805",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773052805",
            "telephone_number": "936-539-4574",
            "fax_number": "936-539-4585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2912 W DAVIS ST",
            "address_2": "SUITE 140",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042041",
            "telephone_number": "936-539-4574",
            "fax_number": "936-539-4585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KID POTENTIAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FAULKNER",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "936-539-4574",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mehik Khawaja, CAA
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• Fatima Sayyad Khuram
• Omar Munawwer Khurshid
• Kidney Care Institute PLLC
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• Segie Kieffer, MOT
• Barry Quentin Kienholz, M.A.
• Kijiji Advocacy Organization

• Comprehensive Outpatient Rehabilitation Facility (CORF) in Conroe, TX
• Providers in Conroe, TX by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.