1881481794 NPI number — LITTLE BLOOM PEDIATRIC PHYSICAL THERAPY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881481794 NPI number — LITTLE BLOOM PEDIATRIC PHYSICAL THERAPY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LITTLE BLOOM PEDIATRIC PHYSICAL THERAPY
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:
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:
1881481794
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/01/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2211 BELLA DAISY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78260-4807
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-900-0190
Provider Business Mailing Address Fax Number:
210-905-0363

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18838 STONE OAK PKWY STE 203
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78258-4179
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-900-0190
Provider Business Practice Location Address Fax Number:
210-905-0363
Provider Enumeration Date:
04/23/2025

Additional Information

Authorized Official

Authorized Official Last Name:
NEER
Authorized Official First Name:
NICOLE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/PHYSICAL THERAPY
Authorized Official Telephone Number:
210-900-0190

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2026 www.npivalidator.com