Provider Demographics
NPI:1376827741
Name:KIDBITZ THERAPY CLINIC, LLC
Entity Type:Organization
Organization Name:KIDBITZ THERAPY CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTIMBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-702-0330
Mailing Address - Street 1:3815 S SUGAR RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-9690
Mailing Address - Country:US
Mailing Address - Phone:956-383-4454
Mailing Address - Fax:956-702-0335
Practice Address - Street 1:105 E EXPY 83 STE F
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-6560
Practice Address - Country:US
Practice Address - Phone:956-702-0330
Practice Address - Fax:956-702-0335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104407235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty