Provider Demographics
NPI:1972749703
Name:CARE FOR KIDS OF TEXAS, PLLC
Entity type:Organization
Organization Name:CARE FOR KIDS OF TEXAS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMERICO
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-400-3542
Mailing Address - Street 1:3949 FREDERICKSBURG RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-3231
Mailing Address - Country:US
Mailing Address - Phone:210-785-8555
Mailing Address - Fax:480-385-2397
Practice Address - Street 1:3949 FREDERICKSBURG RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-3231
Practice Address - Country:US
Practice Address - Phone:210-785-8555
Practice Address - Fax:480-385-2397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12300000X122300000X
TX123G0001X1223G0001X
TX1223P0221X1223P0221X
TX1223X0400X1223X0400X
TX126800000X126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
No126800000XDental ProvidersDental AssistantGroup - Single Specialty