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General NPI Number Information
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NPI Number | 1306236716
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Entity Type | Organization
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Legal Business Name | FUN HOUSE PEDIATRIC THERAPY, LLC
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Dates
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Enumeration Date | 01/24/2015
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Last Update Date | 01/24/2015
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Provider Practice Location Address
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Address Line | 1103 W ACACIA AVE
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City | ALAMO
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State | TX
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Zip | 78516-4424
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Country | US
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Telephone | 956-605-1516
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Fax |
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Provider Business Mailing Address
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Address Line | 1103 W ACACIA AVE
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City | ALAMO
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State | TX
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Zip | 78516-4424
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Country | US
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Telephone | 956-605-1516
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. GEORGINA GARCIA
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Credential | OTR
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Telephone | 956-605-1516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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