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Contact Information

HOLISTIC DEVELOPMENTAL PEDS & INTEGRATIVE MED, PLLC
4940 BROADWAY STE 100
SAN ANTONIO, TX78209-5732
 Phone: 210-403-2343
 Fax: 210-403-2350
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Integrative Medicine

202D00000X
 

Developmental - Behavioral Pediatrics

2080P0006X 37 Physician/Pediatric Medicine
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for HOLISTIC DEVELOPMENTAL PEDS & INTEGRATIVE MED, PLLC

NPI # 1033925789
LBN Legal business name HOLISTIC DEVELOPMENTAL PEDS & INTEGRATIVE MED, PLLC
Authorized official JERI PENKAVA - (SOLE OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/07/2024
Last updated 05/11/2026 - About a month ago
Identifiers
TX Medicaid 520125301
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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