Organization Active NPI

Pediatric Kids Clinic PLLC

  • Primary Care Clinic/Center
  • San Juan, TX
National Provider Identifier
1295561447
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PEDIATRIC KIDS CLINIC PLLC
Practice address
1200 E Business 83 Ste 1200
San Juan, TX 78589-4758
Phone
(956) 396-4525
Fax
(956) 396-4520
NPI assigned
Sep 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Authorized official

Name
Mr. Julio Cesar Morales, FNPNPI 1871019109
Title
Owner
Phone
(956) 396-4525

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

1200 E Business 83 Ste 1200
San Juan, TX 78589-4758

Mailing address

1200 E Bus 83 Ste 1200
San Juan, TX 78589-4758
Phone (956) 396-4525

Other identifiers 1

IdentifierTypeStateIssuer
1871019109MedicaidTX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2316762Pediatric Kids Clinic PLLC1200 E Business 83 Hwy Suite 1200, San Juan, TX 78589RegistrationMay 27, 2028

National Provider Directory

National Provider Directory

Locations

1200 E Business 83
Ste 1200
San Juan, TX 78589
Phone (956) 396-4525

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1726099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752710400000",
    "number": "1295561447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E BUS 83 STE 1200",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "785894758",
            "telephone_number": "956-396-4525",
            "fax_number": "956-396-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E BUSINESS 83 STE 1200",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "785894758",
            "telephone_number": "956-396-4525",
            "fax_number": "956-396-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC KIDS CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-12",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "JULIO",
        "authorized_official_middle_name": "CESAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-396-4525",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871019109",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.