Epic Pediatric Therapy

Primary specialty

Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X

License

212133 Issued in TX

Legal business name

EPIC PEDIATRIC THERAPY

Practice address

6155 Sienna TRL Apt 612
Beaumont, TX 77708-4357

Phone

(786) 797-0382

NPI assigned

Aug 3, 2014

Last updated

Aug 3, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly Gordon

Title

Cota

Phone

(786) 797-0382

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1407024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407024000000",
    "number": "1760891824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6155 SIENNA TRL APT 612",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777084357",
            "telephone_number": "786-797-0382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6155 SIENNA TRL APT 612",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777084357",
            "telephone_number": "786-797-0382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPIC PEDIATRIC THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-03",
        "last_updated": "2014-08-03",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "COTA",
        "authorized_official_telephone_number": "786-797-0382"
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "TX",
            "license": "212133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Enhanced Health & Nutrition Consulting, LLC.
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• Epic Health Services, Inc. (Aveanna Healthcare)
• Ala'Aldin Sami Mahmoud Eqleem, M.D.
• Equilibre Clinic LLC
• Eric a. Marks, MD, PA
• Erica J Hayes M D P a
• Esc IV, L.P. (Brookdale Dowlen Oaks)

• Child Intellectual and/or Developmental Disabilities Respite Care in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Child Intellectual and/or Developmental Disabilities Respite Care in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2014; 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.