Healthcare Provider Details

I. General information

NPI: 1982773198
Provider Name (Legal Business Name): TREEHOUSE PEDIATRIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 NE LOOP 410 SUITE 209
SAN ANTONIO TX
78216-5829
US

IV. Provider business mailing address

85 NE LOOP 410 SUITE 209
SAN ANTONIO TX
78216-5829
US

V. Phone/Fax

Practice location:
  • Phone: 210-340-2627
  • Fax: 210-340-6437
Mailing address:
  • Phone: 210-340-2627
  • Fax: 210-340-6437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. STEPHANIE ALEXIS CRUZ
Title or Position: OFFICE MANAGER
Credential:
Phone: 210-340-2627