Provider Demographics
NPI:1811159684
Name:KIDSTEPS PEDIATRIC THERAPY CENTER, P. C.
Entity type:Organization
Organization Name:KIDSTEPS PEDIATRIC THERAPY CENTER, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NORA
Authorized Official - Middle Name:
Authorized Official - Last Name:JALOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:210-287-4013
Mailing Address - Street 1:1233 OAKCREST DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:TX
Mailing Address - Zip Code:78064-3949
Mailing Address - Country:US
Mailing Address - Phone:210-287-4013
Mailing Address - Fax:210-649-4701
Practice Address - Street 1:9595 US HIGHWAY 87 E
Practice Address - Street 2:SUITE 104-105
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78263-6106
Practice Address - Country:US
Practice Address - Phone:210-649-4700
Practice Address - Fax:210-649-4701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1043107225100000X
TX106873225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX195222802Medicaid