Organization Name: | TRI-COUNTY KIDS CARE |
NPI Number: | 1336442110 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HENRY FERNANDEZ (ADMINISTRATOR) |
Mailing Address: | 1595 W Us Highway 77 Ste C San Benito |
State: | TX US |
Postal Code: | 785864180 |
Phone Number: | 9563994500 |
Fax Number: | 8153019393 |
NPI Enumeration Date: | 12/16/2010 |
NPI Last Update Date: | 12/16/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation |
Taxonomy Definition: |