Provider Demographics
NPI:1932458957
Name:SPECIAL KIDS CARE
Entity Type:Organization
Organization Name:SPECIAL KIDS CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:210-885-9202
Mailing Address - Street 1:21902 TOWER TER
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-2758
Mailing Address - Country:US
Mailing Address - Phone:210-885-9202
Mailing Address - Fax:
Practice Address - Street 1:11124 WURZBACH RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-2438
Practice Address - Country:US
Practice Address - Phone:210-615-5242
Practice Address - Fax:210-615-5280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106671252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency