| NPI | 1104141019 |
|---|---|
| Former Legal Business Name | FANTASTIC KIDS THERAPY PLLC |
| Entity Type | Organization |
| Authorized Contact | AIDE GARZA Managing Member 956-488-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: TX 110165) |
| Enumeration Date | 2010-04-02 |
| Last Update Date | 2010-04-02 |