Organization
KIDIATRIC THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERTO HERNANDEZ C,O.T.A. (PRESIDENT/CFO)
(956) 688-6969
Entity
Organization
Contact information
Practice address
1706 EAST 21ST STREET, MISSION, TX 78572
(956) 688-6969
(956) 688-6970
Mailing address
1706 EAST 21ST STREET, MISSION, TX 78572
(956) 688-6969
(956) 688-6970
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
PENDING
TX
Other
Enumeration date
09/25/2006
Last updated
08/22/2020
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