Provider Demographics
NPI:1871767665
Name:BUILDING BLOKS PEDIATRIC REHAB LTD
Entity type:Organization
Organization Name:BUILDING BLOKS PEDIATRIC REHAB LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / GOVERNING BODY MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:TEOFILO
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-702-9000
Mailing Address - Street 1:6201 S CAGE BLVD
Mailing Address - Street 2:SUITE #3
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-5609
Mailing Address - Country:US
Mailing Address - Phone:956-702-9000
Mailing Address - Fax:956-688-6114
Practice Address - Street 1:6201 S CAGE BLVD
Practice Address - Street 2:SUITE #3
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-5609
Practice Address - Country:US
Practice Address - Phone:956-702-9000
Practice Address - Fax:956-688-6114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX552980001261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1788788-01Medicaid
TX67-6616OtherMEDICARE PROVIDER NO.
TX552980001OtherTEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS