PEDIATRIC THERAPY, INC. (NPI# 1255492864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255492864 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC THERAPY, INC. |
| Practice Address |
4601 66th Street Suite D Lubbock TX 79414 |
| Practice Telephone | 8067933900 |
| Practice Fax Number | 8067933937 |
| Mailing Telephone | 8067933900 |
| Mailing Fax Number | 8067933937 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-01-07 |
| Authorized Official Name | MRS. ALICIA CLARK (PRESIDENT) |
| Authorized Official Telephone | 8668321708 |
| Authorized Official Credential | OT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225XP0200X |
Occupational Therapist Specialization: Pediatrics |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | FIRSTCARE ID | 125383100 | 01 |
| TX | BLUECROSS BLUESHIELD ID | 0189HM | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1302 Teasley Ln, Denton, TX 762057946 | 8668321708 | 8887894391 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902444631 | Pediatric Therapy, Inc. | Clinic/Center | 1302 Teasley Ln Ste D, Denton, TX 76205-7946 | 2019-12-12 |
| 1427696178 | Pediatric Therapy, Inc. | Clinic/Center | 4601 66th St Ste D, Lubbock, TX 79414-4875 | 2019-12-12 |
| 1326407164 | Pediatric Therapy, Inc. | Occupational Therapist | 990 Gill Rd, Batesville, AR 72501-7857 | 2016-02-22 |
| Street Address |
4601 66TH STREET SUITE D |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285717025 | Holli Hodges | Speech-Language Pathologist | 4601 66th Street, Suite D, Lubbock, TX 79414-4828 | 2006-10-23 |
| 1437232261 | Kandra Meshelle Roye | Speech-Language Pathologist | 4601 66th Street, Suite D, Lubbock, TX 79414-4828 | 2006-10-23 |
| 1346323177 | Heidi Payne | Occupational Therapist | 4601 66th Street, Suite D, Lubbock, TX 79414-4828 | 2006-10-23 |
| 1508949330 | Christine Caudle | Occupational Therapist | 4601 66th Street, Suite D, Lubbock, TX 79414-4828 | 2006-10-23 |
| 1770666554 | Pamela Anne Baker | Physical Therapist | 4601 66th Street, Suite D, Lubbock, TX 79414-4828 | 2006-10-23 |
| 1508949306 | Jacquelyn Elaine Hacker | Physical Therapist | 4601 66th Street, Suite D, Lubbock, TX 79414-4828 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275182032 | Ensight Vision LLC | Optometrist | 6002 Slide Road, Lubbock, TX 79414 | 2019-09-05 |
| 1932697604 | Lone Star Mobile Med | Family Medicine | 5504 Wayne Ave Ste 105, Lubbock, TX 79414 | 2018-04-27 |
| 1679986806 | Nicole Evans-taylor | Pharmacist | 4847 Slide Road, Lubbock, TX 79414 | 2014-06-05 |
| 1679911697 | Jamel Deshane Vaughn | Optometrist | 6002 Slide Rd Ste P-8, Lubbock, TX 79414 | 2013-06-12 |
| 1659663284 | Vision One Associates | Optometrist | 6221 Slide Road, Lubbock, TX 79414 | 2011-05-16 |
| 1154445963 | C M Davis Od Pllc | Optometrist | 6002 Slide Road Suite P-8, Lubbock, TX 79414 | 2007-03-19 |
| 1922154632 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 5602 Slide Road, Lubbock, TX 79414 | 2007-01-26 |
| 1043393846 | Emily Rose Bohn | Physical Therapist | 3501 S. Loop 289, Lubbock, TX 79414 | 2006-10-23 |
| 1720176928 | Vann Alexander Home Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 5313 50th Street, Suite D-5, Lubbock, TX 79414 | 2006-10-11 |
| 1952499279 | Bradley Derl Brooks | Dentist | 5301 50th Street #200, Lubbock, TX 79414 | 2006-10-11 |
| Find all providers in zip 79414 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043393846 | Emily Rose Bohn | Physical Therapist | 3501 S. Loop 289, Lubbock, TX 79414 | 2006-10-23 |
| 1821617382 | Elyse Michele Perry | Physical Therapist | 6502 Slide Rd Ste 204, Lubbock, TX 79424-1311 | 2020-04-14 |
| 1609383728 | Megan Stewart | Physical Therapist | 1303 82nd St Ste 150, Lubbock, TX 79423-2385 | 2018-01-10 |
| 1871004440 | Stephen White | Physical Therapist | 6502 Slide Rd Ste 204, Lubbock, TX 79424-1311 | 2017-10-23 |
| 1669846606 | Kara Chaplin | Physical Therapist | 4601 66th St Ste D, Lubbock, TX 79414-4875 | 2015-11-13 |
| 1922484237 | Katie Pickrell | Physical Therapist | 4601 66th St Ste D, 4601 66th Street Suite D, Lubbock, TX 79414-4875 | 2015-08-10 |
| 1205226743 | Roy Eric Hendricks | Physical Therapist | 5225 S Loop 289, Lubbock, TX 79424-1363 | 2015-02-04 |
| 1770986127 | Anitha Thomas | Physical Therapist | 4601 66th St Ste D, Lubbock, TX 79414-4875 | 2014-09-30 |
| 1215347083 | Whitney Layne Talbert | Physical Therapist | 5225 S Loop 289, Suite 210, Lubbock, TX 79424-1363 | 2014-05-02 |
| 1114344355 | Kevin Beaugh | Physical Therapist | 4601 66th St Ste D, Lubbock, TX 79414-4875 | 2014-03-26 |
| Find all providers in LUBBOCK | ||||
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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.