Healthcare Provider Details

I. General information

NPI: 1144944489
Provider Name (Legal Business Name): RISING STAR KIDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2022
Last Update Date: 01/15/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1259 FM 1463 RD STE 100
KATY TX
77494-5474
US

IV. Provider business mailing address

4315 LONE CREEK HILL CT
KATY TX
77494-4151
US

V. Phone/Fax

Practice location:
  • Phone: 917-376-6816
  • Fax:
Mailing address:
  • Phone: 917-376-6816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KAVITA ARORA
Title or Position: MANAGER
Credential: PHD OT
Phone: 540-424-6767