Healthcare Provider Details
I. General information
NPI: 1174276406
Provider Name (Legal Business Name): K KIDS THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/27/2022
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2808 S MAIN ST STE C
LINDALE TX
75771-7854
US
IV. Provider business mailing address
PO BOX 2350
LINDALE TX
75771-2350
US
V. Phone/Fax
- Phone: 903-780-6596
- Fax: 903-881-6010
- Phone: 903-780-6596
- Fax: 844-832-3666
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225XP0200X |
| Taxonomy | Pediatric Occupational Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251P0200X |
| Taxonomy | Pediatric Physical Therapist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RHONDA
JILL
KIRKPATRICK
Title or Position: OWNER/ CLINICIAN
Credential: OTR
Phone: 903-780-6596