Provider Demographics
NPI:1316073240
Name:KIDS 'N TEENS CLINICS, P.A.
Entity type:Organization
Organization Name:KIDS 'N TEENS CLINICS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:ISART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-681-7334
Mailing Address - Street 1:2925 W T C JESTER BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-7050
Mailing Address - Country:US
Mailing Address - Phone:713-681-7334
Mailing Address - Fax:
Practice Address - Street 1:2925 W T C JESTER BLVD STE 4
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-7050
Practice Address - Country:US
Practice Address - Phone:281-448-5437
Practice Address - Fax:281-448-2988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081128304Medicaid
TX326618102Medicaid
TX325942602Medicaid
TX325942601Medicaid
TX081128301Medicaid
TX326618101Medicaid