Provider Demographics
NPI:1538713904
Name:THE TEXAS INSTITUTE OF DEVELOPMENTAL PEDIATRICS
Entity type:Organization
Organization Name:THE TEXAS INSTITUTE OF DEVELOPMENTAL PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER- EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-552-4418
Mailing Address - Street 1:2204 TROLLEY CV
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-2098
Mailing Address - Country:US
Mailing Address - Phone:303-552-4418
Mailing Address - Fax:
Practice Address - Street 1:2204 TROLLEY CV
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-2098
Practice Address - Country:US
Practice Address - Phone:303-552-4418
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Multi-Specialty
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No385HR2050XRespite Care FacilityRespite CareRespite Care CampGroup - Multi-Specialty