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NPI Code Detail

MEDICARE: KIDS DC, LLC

MEDICARE: KIDS DC, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency
2261QR0400XRehabilitation Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225076904
Entity Type Code : Organization
Provider Name (Legal Business Name) : KIDS DC, LLC
Provider Business Mailing Address
First Line : 8021 BISSONNET ST
Second Line :
City : HOUSTON
State : TX
Zip : 77074-5200
Country : US
Telephone Number : 713-774-5437
Fax Number : 713-774-5445
Provider Business Practice Location Address
First Line : 8021 BISSONNET ST
Second Line :
City : HOUSTON
State : TX
Zip : 77074-5200
Country : US
Telephone Number : 713-774-5437
Fax Number : 713-774-5445
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. DIANA P. DINN
Credential : PT, MBA
Telephone Number : 713-774-5437
Provider Enumeration Date : 06/03/2006
Last Update Date : 11/01/2021

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Directions to “KIDS DC, LLC ” Practice Location

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