NPIMap

Organization Active NPI

Magical Kids Therapy

Doing business as Magical Kids Therapy, PLLC

  • Rehabilitation Clinic/Center
  • Laredo, TX
National Provider Identifier
1255612412
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
MAGICAL KIDS THERAPY
Doing business as
Magical Kids Therapy, PLLC
Practice address
3507 Jaime Zapata Memorial Hwy
Ste 1 & 2
Laredo, TX 78043-4769
Phone
(956) 753-6355
Fax
(956) 753-6331
NPI assigned
Sep 1, 2011
Last updated
Jan 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Authorized official

Name
Ms. Elizabeth G. Trevino
Title
Owner
Phone
(956) 753-6355

Specialties & licenses 1

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

Addresses

Primary practice location

3507 Jaime Zapata Memorial Hwy
Ste 1 & 2
Laredo, TX 78043-4769

Mailing address

3507 Jaime Zapata Memorial Hwy
Ste 1 & 2
Laredo, TX 78043-4769
Phone (956) 753-6355

Other identifiers 2

IdentifierTypeStateIssuer
676709OtherTXMEDICARE PTAN
332120001MedicaidTX

Other names 1

  • MAGICAL KIDS THERAPY, PLLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110920000831 TX Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 9436320678 Practice locations: Laredo, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255612412. Details of each certification follow.

  • CCN 676810 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 676810

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
MAGICAL KIDS THERAPY LLC
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
May 13, 2025
Last certification
May 13, 2025
Ownership / control type
Proprietary
Facility address
3507 Jaime Zapata Memorial Hwy Ste 1&2
Laredo, TX 78043

National Provider Directory

National Provider Directory
Tax ID family
Fantastic Kids Therapy PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3507 Jaime Zapata Memorial Hwy
Ste 1
Laredo, TX 78043
Phone (956) 753-6355

3507 Jaime Zapata Memorial Hwy
Ste 12
Laredo, TX 78043
Phone (956) 735-0188

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1255612412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3507 JAIME ZAPATA MEMORIAL HWY",
            "address_2": "STE 1 & 2",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780434769",
            "telephone_number": "956-753-6355",
            "fax_number": "956-753-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3507 JAIME ZAPATA MEMORIAL HWY",
            "address_2": "STE 1 & 2",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780434769",
            "telephone_number": "956-753-6355",
            "fax_number": "956-753-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGICAL KIDS THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-01",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "TREVINO",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-753-6355",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "676709",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "332120001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAGICAL KIDS THERAPY, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.