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General NPI Number Information
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NPI Number | 1194500157
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Entity Type | Organization
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Legal Business Name | HEALTHCARE FOR KIDS TX, LLC
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Dates
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Enumeration Date | 08/29/2023
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Last Update Date | 06/28/2024
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Provider Practice Location Address
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Address Line | 16019 NACOGDOCHES RD
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City | SAN ANTONIO
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State | TX
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Zip | 78247-1118
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Country | US
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Telephone | 239-403-0402
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Fax |
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Provider Business Mailing Address
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Address Line | 576 COLONIAL PARK DR STE 120
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City | ROSWELL
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State | GA
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Zip | 30075-3794
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | JOSEPH HARRELSON
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Credential |
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Telephone | 239-403-0402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM3000X
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Taxonomy Name | Medically Fragile Infants and Children Day Care
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License Number |
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License Number State |
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