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NEO2TEEN PEDIATRIC CLINIC, PA
NPI 1770023624
Pediatrics in San Antonio, TX

Active since February 26, 2017CLIA 45D2132318 · Waiver
6735 FM 78, SUITE 103, SAN ANTONIO, TX 78244(210) 888-9960(210) 888-9422 Get Directions Write a Review

NPPES record last updated: April 27, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 27, 2017, Feb 26, 2017 (2 updates tracked since 2017).

About Neo2teen Pediatric Clinic, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NEO2TEEN PEDIATRIC CLINIC, PA (NPI 1770023624) is a healthcare organization registered as a pediatrics in San Antonio, Texas and active in the NPI registry since February 2017. The organization holds a CLIA Waiver certificate valid through June 15, 2027 and lists Kenneth Etokhana, President, as its authorized official.

NPPES Registry Identity

NPI1770023624
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameNEO2TEEN PEDIATRIC CLINIC, PA
Location Address6735 FM 78, SUITE 103San Antonio, TX 78244-1367
Mailing Address23723 Sunset PeakSan Antonio, TX 78258-7544 · (210) 888-9960 · Fax (210) 888-9422
Phone(210) 888-9960
Fax(210) 888-9422
Organization SubpartNo
Authorized OfficialKenneth EtokhanaPresident · (210) 888-9960
Enumeration DateFebruary 26, 2017
Last NPPES UpdateApril 27, 20172 updates tracked since enumeration
✔ NPI 1770023624 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in TX · P2438
Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

6735 FM 78, San Antonio, TX 78244
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2132318

Neo2teen Pediatric Clinic · San Antonio, TX
Active · expires Jun 15, 2027
CLIA Number45D2132318
Laboratory TypePhysician Office
Certificate Effective DateJune 16, 2025
Certificate Expiration DateJune 15, 2027
Laboratory DirectorKenneth O. Etokhana
Laboratory Phone(210) 888-9960
Laboratory LocationNeo2teen Pediatric Clinic6735 Fm 78, Suite 102, San Antonio, TX 78244
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

M M ORTHODONTICS PA
Dentist (Orthodontics and Dentofacial Orthopedics)
6735 FM 78, SUITE 102
SAN ANTONIO, TX 78244
Bexar County (210) 667-2929
DR. CARLOS FREYMANN III D.D.S
Dentist (General Practice)
6735 FM 78, 101
SAN ANTONIO, TX 78244
Bexar County (210) 661-6200
CARLOS FREYMANN, III, D.D.S., P.A.
Dentist (General Practice)
6735 FM 78, STE. 101
SAN ANTONIO, TX 78244
Bexar County (210) 661-6200
SD-HWY 78 PC
Dentist (General Practice)
6735 FM 78, SUITE 106
SAN ANTONIO, TX 78244
Bexar County (210) 667-2929

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Neo2teen Pediatric Clinic, PA's NPI number?

The NPI number for Neo2teen Pediatric Clinic, PA is 1770023624. It was assigned to this organization in the NPPES registry on February 26, 2017.

Where is Neo2teen Pediatric Clinic, PA located?

Neo2teen Pediatric Clinic, PA is located at 6735 Fm 78 Suite 103, San Antonio, TX 78244. The listed phone number is (210) 888-9960.

What is Neo2teen Pediatric Clinic, PA's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Neo2teen Pediatric Clinic, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2132318) is associated with this NPI, valid through June 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Neo2teen Pediatric Clinic, PA accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Neo2teen Pediatric Clinic, PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Neo2teen Pediatric Clinic, PA was last updated on April 27, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.