Provider Demographics
NPI:1588607857
Name:BROWNSVILLE SOCIETY FOR CRIPPLED CHILDREN INC
Entity Type:Organization
Organization Name:BROWNSVILLE SOCIETY FOR CRIPPLED CHILDREN INC
Other - Org Name:MOODY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SEARS
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC SLP
Authorized Official - Phone:956-542-8504
Mailing Address - Street 1:1901 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-2956
Mailing Address - Country:US
Mailing Address - Phone:956-542-8504
Mailing Address - Fax:956-542-6510
Practice Address - Street 1:1901 E 22ND ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-2956
Practice Address - Country:US
Practice Address - Phone:956-542-8504
Practice Address - Fax:956-542-6510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1060085225100000X
TX110794225X00000X
TX10468235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty