NPIMap

Organization Active NPI

South Texas Direct Kids LLC

  • Physical Therapist
  • Laredo, TX
National Provider Identifier
1881347441
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SOUTH TEXAS DIRECT KIDS LLC
Practice address
1405 Jacaman Rd Ste 106
Laredo, TX 78041-6225
Phone
(956) 608-3050
Fax
(956) 608-3097
NPI assigned
Feb 2, 2022
Last updated
Mar 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Authorized official

Name
Virgilio Vazquez Garcia, SLP-CCCNPI 1609122415
Title
Owner
Phone
(956) 324-9014

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

1405 Jacaman Rd Ste 106
Laredo, TX 78041-6225

Mailing address

1405 Jacaman Rd Ste 106
Laredo, TX 78041-6225
Phone (956) 602-1390

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL WebPT Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220404001799 TX Part B Supplier - Clinic/Group Practice 1658767454 Receives reassigned benefits from 4 practitioners
Practice locations: Laredo, TX

National Provider Directory

National Provider Directory

Locations

1405 Jacaman Rd
Ste 106
Laredo, TX 78041
Phone (956) 568-0003

Practitioners & affiliated clinicians

Practitioners 7

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": "1643760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679616000000",
    "number": "1881347441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 JACAMAN RD STE 106",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780416225",
            "telephone_number": "956-602-1390",
            "fax_number": "956-602-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 JACAMAN RD STE 106",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780416225",
            "telephone_number": "956-608-3050",
            "fax_number": "956-608-3097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH TEXAS DIRECT KIDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-02",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "VIRGILIO",
        "authorized_official_middle_name": "VAZQUEZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-324-9014",
        "authorized_official_credential": "SLP-CCC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "WebPT",
            "affiliation": "N",
            "endpointDescription": "WebPT",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1405 Jacaman Rd Ste 106",
            "city": "Laredo",
            "state": "TX",
            "country_code": "US",
            "postal_code": "780416225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.