Funtastic Kids Therapy

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

FUNTASTIC KIDS THERAPY

Practice address

1501 E. Bustamante Suite G
Laredo, TX 78041

Phone

(956) 718-2020

Fax

(956) 718-2919

NPI assigned

Nov 29, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Joanna Mendoza, M. S. CCC-SLPNPI 1457539959

Title

Owner/Speech Pathologist

Phone

(956) 718-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Joanna Riojas Mendoza, SLP

  • Speech-Language Pathologist
  • Laredo, TX
  • NPI 1457539959
  NPD (past) Authorized official
• Terri R Gonzalez, ED.D., OTR, LMT

  • Contractor
  • Laredo, TX
  • NPI 1174824379
  NPD (past)

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

{
    "created_epoch": "1290988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646870400000",
    "number": "1811299720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 E. BUSTAMANTE SUITE G",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "78041",
            "telephone_number": "956-718-2020",
            "fax_number": "956-718-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E. BUSTAMANTE SUITE G",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "78041",
            "telephone_number": "956-718-2020",
            "fax_number": "956-718-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNTASTIC KIDS THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-29",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_title_or_position": "OWNER/SPEECH PATHOLOGIST",
        "authorized_official_telephone_number": "956-718-2020",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M. S. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190441903",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yeseidi L Fuentes Gonzalez
• Elizabeth Fuentes Torres, RN
• Carlos Alberto Fuentes, R.PH., ABOC
• Elsa G. Fuentes, R.PH.
• Nimol Fuller
• G M M Counseling & Consulting
• G. G. Medical, Inc.
• Tiffany Hope Gagnon, LVN
• Purvi Gala, OD
• Anthony R Galan, M.D.

• Speech-Language Pathologist in Laredo, TX
• Providers in Laredo, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.