Kids Clinic PA

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

H3035 Issued in TX

Legal business name

KIDS CLINIC PA

Practice address

7017 S Staples St
Ste 101
Corpus Christi, TX 78413-5507

Phone

(361) 994-7255

Fax

(361) 994-7740

NPI assigned

Apr 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. William A Fader, MD

Title

Physician

Phone

(361) 994-7255

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Kid'S Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Kid'S Clinic

  • Primary Care Clinic/Center
  • Corpus Christi, TX
  • NPI 1093105934
  NPD tax ID

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377734400000",
    "number": "1376767913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7017 S STAPLES ST",
            "address_2": "STE 101",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784135507",
            "telephone_number": "361-994-7255",
            "fax_number": "361-994-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7017 S STAPLES ST",
            "address_2": "STE 101",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784135507",
            "telephone_number": "361-994-7255",
            "fax_number": "361-994-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2013-08-29",
        "status": "A",
        "authorized_official_last_name": "FADER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "361-994-7255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "TX",
            "license": "H3035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121271401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121271404",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Khoa D Le MD PA
• Kid'S Clinic
• Kidney Care Clinic of Corpus Christi
• Kidney Specialists of South Texas, P.a.
• Kids Clinic
• Christopher John Kight, DMD
• Karla Fuentes Kiker, MD
• Kentaro Kikuchi, O.D.
• Angela Kilbourn, LPC
• Shelby Killion, R.D.,L.D.

• Preferred Provider Organization in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Preferred Provider Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; 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.