Organization Active NPI

Kidiatric Therapy Services

  • Rehabilitation Clinic/Center
  • Mission, TX
National Provider Identifier
1154422061
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
PENDING Issued in TX
Legal business name
KIDIATRIC THERAPY SERVICES
Practice address
1706 East 21St Street
Mission, TX 78572
Phone
(956) 688-6969
Fax
(956) 688-6970
NPI assigned
Sep 25, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Roberto Hernandez, C,O.T.A.
Title
President/Cfo
Phone
(956) 688-6969

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X PENDING TX Primary

Addresses

Primary practice location

1706 East 21St Street
Mission, TX 78572

Mailing address

1706 East 21St Street
Mission, TX 78572
Phone (956) 688-6969

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154422061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 EAST 21ST STREET",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "78572",
            "telephone_number": "956-688-6969",
            "fax_number": "956-688-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 EAST 21ST STREET",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "78572",
            "telephone_number": "956-688-6969",
            "fax_number": "956-688-6970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDIATRIC THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_title_or_position": "PRESIDENT/CFO",
        "authorized_official_telephone_number": "956-688-6969",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C,O.T.A."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission, TX

Sources for this page

  • 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.