Provider Demographics
NPI:1790177012
Name:REMARKABLE KIDS PEDIATRIC THERAPY CENTER, LLC
Entity Type:Organization
Organization Name:REMARKABLE KIDS PEDIATRIC THERAPY CENTER, LLC
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ALTERNATE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:V
Authorized Official - Last Name:MCZEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-309-8710
Mailing Address - Street 1:500 SPRING HILL DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-6023
Mailing Address - Country:US
Mailing Address - Phone:281-309-8710
Mailing Address - Fax:
Practice Address - Street 1:500 SPRING HILL DR
Practice Address - Street 2:SUITE 110
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-6023
Practice Address - Country:US
Practice Address - Phone:281-309-8710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-24
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation