Provider Demographics
NPI:1952911729
Name:SOUTHEAST TEXAS PEDIATRIC THERAPY, PLLC
Entity Type:Organization
Organization Name:SOUTHEAST TEXAS PEDIATRIC THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAPER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:254-644-2770
Mailing Address - Street 1:6275 PARK WEST DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-7637
Mailing Address - Country:US
Mailing Address - Phone:254-644-2770
Mailing Address - Fax:
Practice Address - Street 1:295 FLAMINGO ST
Practice Address - Street 2:
Practice Address - City:VIDOR
Practice Address - State:TX
Practice Address - Zip Code:77662-9478
Practice Address - Country:US
Practice Address - Phone:254-644-2770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-05
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty