Provider Demographics
NPI:1417484114
Name:KIDZ-R-US
Entity Type:Organization
Organization Name:KIDZ-R-US
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-499-3720
Mailing Address - Street 1:PO BOX 79855
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77279-9855
Mailing Address - Country:US
Mailing Address - Phone:936-499-3720
Mailing Address - Fax:888-664-6404
Practice Address - Street 1:12808 VETERANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-2004
Practice Address - Country:US
Practice Address - Phone:936-499-3720
Practice Address - Fax:888-664-6404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX086931041C0700X
TX568702163W00000X
208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty