Provider Demographics
NPI:1558612549
Name:ESTERS KINGDOM
Entity Type:Organization
Organization Name:ESTERS KINGDOM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONDALYN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-757-3398
Mailing Address - Street 1:22 MOONWALK CRST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-2512
Mailing Address - Country:US
Mailing Address - Phone:210-757-3398
Mailing Address - Fax:
Practice Address - Street 1:22 MOONWALK CRST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-2512
Practice Address - Country:US
Practice Address - Phone:210-757-3398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care