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General NPI Number Information
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NPI Number | 1629488754
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Entity Type | Organization
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Legal Business Name | CONNECT 2 TOTS, LLC
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Dates
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Enumeration Date | 04/29/2014
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Last Update Date | 04/29/2014
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Provider Practice Location Address
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Address Line | 3112 BEDFORD RD
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City | BEDFORD
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State | TX
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Zip | 76021-7373
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Country | US
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Telephone | 817-371-8080
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Fax | 817-977-5393
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Provider Business Mailing Address
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Address Line | PO BOX 211061
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City | BEDFORD
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State | TX
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Zip | 76095-8061
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Country | US
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Telephone | 817-371-8080
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Fax | 817-977-5393
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Authorized Official
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Title or Position | OWNER/ DIRECTOR
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Name | KE'ANNA MAYWEATHER
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Credential | O.T.R.
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Telephone | 817-371-8080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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