KID POTENTIAL, INC. (NPI# 1124175237) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124175237 |
| Entity Type | Organization |
| Organization Name | KID POTENTIAL, INC. |
| Practice Address |
2912 W Davis St Suite 140 Conroe TX 77304-2041 |
| Mailing Address |
Po Box 2805 Conroe TX 77305-2805 |
| Practice Telephone | 9365394574 |
| Practice Fax Number | 9365394585 |
| Mailing Telephone | 9365394574 |
| Mailing Fax Number | 9365394585 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. JUDY FAULKNER (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 9365394574 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0401X |
Clinic/Center Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
TX | Ambulatory Health Care Facilities |
| Street Address |
2912 W DAVIS ST SUITE 140 |
| City | CONROE |
| State | TX |
| Zip Code | 77304-2041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386698876 | Sadler Clinic Association | Clinic/Center | 2912 W Davis St, Conroe, TX 77304-2041 | 2006-05-20 |
| 1538547864 | Stephanie Fox Castleschouldt | Specialist | 2912 W Davis St, Suite 130c, Conroe, TX 77304-2041 | 2015-05-06 |
| 1154607752 | Kristy Dawn Buchanan | Counselor | 2912 W Davis St, Suite 322, Conroe, TX 77304-2041 | 2011-10-26 |
| 1427096049 | Nico Halter | Physical Therapist | 2912 W Davis St, Conroe, TX 77304-2041 | 2006-06-04 |
| 1689611246 | Sadler Clinic Association | Clinic/Center | 2912 W Davis St, Conroe, TX 77304-2041 | 2006-06-01 |
| 1225082613 | Sadler Clinic Association | Clinic/Center | 2912 W Davis St, Conroe, TX 77304-2041 | 2006-05-20 |
| 1679527071 | Sadler Clinic Association | Clinic/Center | 2912 W Davis St, Conroe, TX 77304-2041 | 2006-05-20 |
| 1659325058 | Sadler Clinic Association | Clinic/Center | 2912 W Davis St, Conroe, TX 77304-2041 | 2006-05-20 |
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|---|---|---|---|---|
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| 1922591411 | Bradley Leiker II | Dentist | 381 South Loop 336 West Suite 500, Conroe, TEXAS 77304 | 2018-06-11 |
| 1598266009 | Chapman Pain Consultants | Anesthesiology | 4015 I45 North, Suite 230-1, Conroe, TX 77304 | 2018-02-21 |
| 1063932366 | Jonathan Garcia | Specialist/Technologist | 1716 Summergate Drive, Conroe, TX 77304 | 2017-06-27 |
| 1932634169 | 3083 Imaging LLC | Clinic/Center | 1246 N Fm 3083 West, Conroe, TX 77304 | 2017-04-25 |
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| 1093165615 | Melanie Kay Plaster | Behavioral Analyst | 2626 Silver Shadow, Conroe, TX 77304 | 2016-06-14 |
| 1508249798 | Conroe Willis Family Medicine, Pllc | Family Medicine | 4015 I 45 N Ste 220, Conroe, TX 77304 | 2015-07-07 |
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| Taxonomy Code | 261QR0401X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Definition to come... |
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|---|---|---|---|---|
| 1710996335 | Beyond Boundaries Therapy Center, Pllc | Clinic/Center | 704 Longmire Rd Ste 101, Conroe, TX 77304-1850 | 2006-08-05 |
| 1982872883 | Selous Healthcare LLC | Clinic/Center | 704 Longmire Rd, Suite 101, Conroe, TX 77304-1850 | 2008-02-13 |
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| 1023544418 | Medcare Pediatric Rehab Center, Lp | Clinic/Center | 5095 Preston Ave, Pasadena, TX 77505-2053 | 2017-05-04 |
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| 1801242839 | Transitional Learning Center At Galveston | Clinic/Center | 4416 10th St, Lubbock, TX 79416-4800 | 2016-05-09 |
| 1225401805 | Milestones | Clinic/Center | 2704 S 26th St, Mcallen, TX 78503-7812 | 2015-11-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.