1629465943 NPI number — THE CHILDREN'S S.P.O.T.

Table of content: (NPI 1629465943)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629465943 NPI number — THE CHILDREN'S S.P.O.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE CHILDREN'S S.P.O.T.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629465943
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/30/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6222 W INTERSTATE 10 STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78201-2015
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-698-9844
Provider Business Mailing Address Fax Number:
210-698-3220

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
133 WINDY MEADOWS DR STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCHERTZ
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78154-3102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-698-9844
Provider Business Practice Location Address Fax Number:
210-698-3220
Provider Enumeration Date:
04/24/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KARL
Authorized Official First Name:
GINA
Authorized Official Middle Name:
Authorized Official Title or Position:
ACCOUNTS RECEIVABLE/BILLING DIRECTO
Authorized Official Telephone Number:
210-698-9844

Provider Taxonomy Codes

  • Taxonomy code: 261QR0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)