CHILD STUDY CLINIC (NPI# 1467576041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467576041 |
| Entity Type | Organization |
| Organization Name | CHILD STUDY CLINIC |
| Other Organization Name | S.T.A.R.S. |
| Practice Address |
4208 Retama Cir Victoria TX 77901-2765 |
| Mailing Address |
Po Box 5140 Victoria TX 77903-5140 |
| Practice Telephone | 3615750681 |
| Practice Fax Number | 3615750100 |
| Mailing Telephone | 3615750681 |
| Mailing Fax Number | 3615750100 |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2016-08-31 |
| Authorized Official Name | KATIE SERRANO (CLINIC COORDINATOR I) |
| Authorized Official Telephone | 3615750681 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
G6459 | TX | Allopathic & Osteopathic Physicians |
| N | 163WC0400X |
Registered Nurse Specialization: Case Management |
618622 | TX | Nursing Service Providers |
| N | 163WC0400X |
Registered Nurse Specialization: Case Management |
649214 | TX | Nursing Service Providers |
| N | 171M00000X | Case Manager/Care Coordinator | G6459 | TX | Other Service Providers |
| N | 174H00000X | Health Educator | G6459 | TX | Other Service Providers |
| Y | 2080P0006X |
Pediatrics Specialization: Developmental – Behavioral Pediatrics |
G6459 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 126856702 | 05 |
| Other Name | Type Code |
|---|---|
| S.T.A.R.S. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871740860 | Child Study Clinic | Specialist | 117 Medical Dr Ste 4, Victoria, TX 77904-3114 | 2008-08-21 |
| 1134384068 | Child Study Clinic | Specialist | 117 Medical Dr, Ste 4, Victoria, TX 77904-3114 | 2008-07-21 |
| 1396869780 | Child Study Clinic | Case Manager/Care Coordinator | 117 Medical Dr Ste 4, Victoria, TX 77904-3114 | 2007-03-19 |
| Street Address |
4208 RETAMA CIR |
| City | VICTORIA |
| State | TX |
| Zip Code | 77901-2765 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518997949 | Jrjs Healthcare Operations LLC | Clinic/Center | 4208 Retama Cir, Victoria, TX 77901-2765 | 2006-07-03 |
| 1114572187 | Hatch Ventures, LLC | Behavioral Analyst | 4208 Retama Cir, Victoria, TX 77901-2765 | 2019-08-07 |
| 1659923837 | Stacey Perez | Speech-Language Pathologist | 4208 Retama Cir, Victoria, TX 77901-2765 | 2019-07-09 |
| 1730641309 | Peyton Ratliff Speed | Occupational Therapist | 4208 Retama Cir, Victoria, TX 77901-2765 | 2019-04-03 |
| 1790161461 | Larae Wieland | Speech-Language Pathologist | 4208 Retama Cir, Victoria, TX 77901-2765 | 2015-08-05 |
| 1689096539 | Kevin Dale Lange | Physical Therapist | 4208 Retama Cir, Victoria, TX 77901-2765 | 2014-01-13 |
| 1811327109 | Building Kid Steps, LLC | Physical Therapist | 4208 Retama Cir, Suite 4, Victoria, TX 77901-2765 | 2013-11-22 |
| 1841626371 | Ashley Fay Hermes | Occupational Therapist | 4208 Retama Cir, Victoria, TX 77901-2765 | 2013-09-16 |
| 1265786537 | Brianne Lynn Harryman | Physical Therapist | 4208 Retama Cir, Victoria, TX 77901-2765 | 2012-11-07 |
| 1821357393 | Krystal Perez | Speech-Language Pathologist | 4208 Retama Cir, Victoria, TX 77901-2765 | 2012-05-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457962540 | Uc Management Group LLC | Nurse Practitioner | 1908 N Laurent St Ste 410, Victoria, TX 77901 | 2020-08-12 |
| 1558823336 | Uzoma Melissa Obi-nwankwo | Family Medicine | Detar Family Medicine Center, 501 E Colorado St., Victoria, TX 77901 | 2019-04-02 |
| 1871058099 | Still Water Springs | Counselor | 103 East Airline Road, Suite 3, Victoria, TX 77901 | 2019-02-01 |
| 1811488349 | Victoria Np Clinic Pllc | Nurse Practitioner | 606 E. Nueces St, Victoria, TX 77901 | 2018-05-21 |
| 1003324823 | Raul Hernandez | Physical Therapy Assistant | 101 W Goodwin Ave Ste 600, Victoria, TX 77901 | 2018-01-15 |
| 1568916153 | Bdcv / Vpsc Associates, LLC | Dietitian, Registered | 4206 N Ben Jordan Street, Victoria, TX 77901 | 2016-08-11 |
| 1801349535 | James H Jarrett Jr. | Dietitian, Registered | 4206 N. Ben Jordan Street, Victoria, TX 77901 | 2016-07-29 |
| 1508218736 | Philip Henneke | Case Manager/Care Coordinator | 1802 N. Laurent, Victoria, TX 77901 | 2016-07-12 |
| 1194084145 | Kelly E. Rogers | Speech-Language Pathologist | 2903 B. Azalea St., Victoria, TX 77901 | 2012-05-11 |
| 1023393790 | Frederick B Niegos Mdpa | Internal Medicine | 2700 Citizens Plaza, Suite 206, Victoria, TX 77901 | 2011-10-13 |
| Find all providers in zip 77901 | ||||
| Taxonomy Code | 2080P0006X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Developmental – Behavioral Pediatrics |
| A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed, 3/26/2008: definition corrected] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932615234 | Pediatrics Plus Therapy | Pediatrics | 6025 Sports Village Road, Frisco, TX 75033 | 2017-12-21 |
| 1508371824 | Kamvic Home Health Care LLC | Pediatrics | 21111 Barton Hollow Ln, Richmond, TX 77407-6416 | 2017-12-08 |
| 1962838458 | Sheri Michelle Ravenscroft | Pediatrics | 5359 N Ih 35 Frontage Rd, Ste 100, Austin, TX 78723-6300 | 2013-09-17 |
| 1467650564 | Charles Mike Rios | Pediatrics | 1100 S. Main St. #103, Grapevine, TX 76051 | 2007-07-10 |
| 1891908901 | Harold Mark Welch Jr. | Pediatrics | 3019 Medlin Dr, Suite 100, Arlington, TX 76015-2307 | 2007-05-07 |
| 1699987651 | Peter Campbell Ray | Pediatrics | 8300 Douglas Ave Ste 731, Dallas, TX 75225-5825 | 2007-05-03 |
| 1447384706 | Julie Jacob | Pediatrics | 8501 Wade Blvd Ste 330, Frisco, TX 75034-6264 | 2007-03-16 |
| 1134285430 | Jeri L Penkava | Pediatrics | 1370 Pantheon Way Ste 250, San Antonio, TX 78232-2290 | 2006-12-29 |
| 1598873135 | Beatrice Thetgyi Ting | Pediatrics | 3607 Rivera Ave, El Paso, TX 79905-2415 | 2006-08-25 |
| 1699718205 | Heidi A Castillo | Pediatrics | 6701 Fannin Street, Suite 1530, Houston, TX 77030 | 2006-06-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.