Healthcare Provider Details

I. General information

NPI: 1124631437
Provider Name (Legal Business Name): KIDS CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2020
Last Update Date: 08/26/2020
Certification Date: 08/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E HOUSTON ST
BEEVILLE TX
78102-4941
US

IV. Provider business mailing address

500 E HOUSTON ST
BEEVILLE TX
78102
US

V. Phone/Fax

Practice location:
  • Phone: 361-542-4355
  • Fax: 833-989-2081
Mailing address:
  • Phone: 361-542-4355
  • Fax: 833-989-2081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number
License Number State

VIII. Authorized Official

Name: GLORIA R ALVAREZ
Title or Position: MEDICAL OFFICE ADMINISTRATOR
Credential:
Phone: 361-537-5715