OrganizationActive
Region III Education Service Center
NPI 1003981572 · Early Intervention Provider Agency · Victoria, TX
Provider details
- NPI number
- 1003981572
- Entity type
- Organization
- Primary specialty
- Early Intervention Provider AgencyAgencies
- Organization subpart
- No
- Authorized official
- Angie Bolom, Coordinator of Therapy Services(361) 573-0731
Specialties & taxonomies
Agencies
- Registered Dietitian133V00000X
Dietary & Nutritional Service Providers
- Physical Therapist225100000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Professional Counselor101YP2500X
Behavioral Health & Social Service Providers
- Occupational Therapist225X00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Speech-Language Pathologist235Z00000X
Speech, Language and Hearing Service Providers
Practice location
1905 Leary Ln
Victoria, TX 77901-2818
Phone: (361) 573-0731
Fax: (361) 573-1594
Approximate (ZIP-level) locationGet directions
Mailing address
1905 Leary Ln
Victoria, TX 77901-2818
Registry dates
- Enumerated
- 2006-11-21
- Last updated
- 2024-06-12
- Certified
- 2024-06-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.