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

NPI Status: Active since February 26, 2017

Contact Information

6735 FM 78
SUITE 103
SAN ANTONIO, TX
ZIP 78244
Phone: (210) 888-9960
Fax: (210) 888-9422

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  • Organization
  • Pediatrics
  • Accepts Insurance
  • CLIA Number: 45D2132318
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 06-15-2027

About NEO2TEEN PEDIATRIC CLINIC, PA

This page provides the complete NPI Profile along with additional information for Neo2teen Pediatric Clinic, Pa, a pediatrician established in San Antonio, Texas operating as a Pediatrics. The healthcare provider is registered in the NPI registry with number 1770023624 assigned on February 2017. The practitioner's primary taxonomy code is 208000000X with license number P2438 (TX). The provider is registered as an organization and their NPI record was last updated 9 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Kenneth Etokhana Md (President)

NPI
1770023624
Provider Name
NEO2TEEN PEDIATRIC CLINIC, PA
Entity Type
Organization
Location Address
6735 FM 78 SUITE 103 SAN ANTONIO, TX 78244
Location Phone
(210) 888-9960
Location Fax
(210) 888-9422
Mailing Address
23723 SUNSET PEAK SAN ANTONIO, TX 78258
Mailing Phone
(210) 888-9960
Mailing Fax
(210) 888-9422
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-26-2017
Last Update Date
04-27-2017
Code Navigator

A pediatrician like Neo2teen Pediatric Clinic, Pa is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pediatrics

Taxonomy Code
208000000X
Type
Allopathic & Osteopathic Physicians
License No.
P2438
License State
TX
Taxonomy Description
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.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Choice Bronze HSA (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoice) + Vision + Adult Dental - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold - PPO
  • Elite Gold + Vision + Adult Dental - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Molina Gold Core 1640 - HMO
  • Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
  • Molina Gold Core 1640 Plus with Adult Vision - HMO
  • Molina Gold Saver 750 - HMO
  • Molina Gold Saver 750 Plus with Adult Dental and Vision - HMO
  • Molina Gold Saver 750 Plus with Adult Vision - HMO
  • Molina Gold Standard - HMO
  • Molina Silver Core - HMO
  • Molina Silver Core Plus with Adult Dental and Vision - HMO
  • Molina Silver Core Plus with Adult Vision - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KENNETH ETOKHANA MD

Authorized Official Title
PRESIDENT
Authorized Official Phone
(210) 888-9960

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
45D2132318
Facility Type
Physician Office
Certificate Effective Date
June 16, 2025
Certificate Expiration Date
June 15, 2027
Laboratory Director
KENNETH O. ETOKHANA
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Neo2teen Pediatric Clinic, Pa to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for NEO2TEEN PEDIATRIC CLINIC, PA

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1770023624, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
0
Unchanged
Pos 5
0
Doubled → 0
Pos 6
2
Unchanged
Pos 7
3
Doubled → 6
Pos 8
6
Unchanged
Pos 9
2
Doubled → 4
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 0 → 0 3 → 6 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 4 + 0 + 0 + 2 + 6 + 6 + 4 + 24 = 56

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1770023624.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Dentist (Orthodontics and Dentofacial Orthopedics)
6735 FM 78, SUITE 102
SAN ANTONIO, TX 78244
Dentist (General Practice)
6735 FM 78, 101
SAN ANTONIO, TX 78244
Dentist (General Practice)
6735 FM 78, STE. 101
SAN ANTONIO, TX 78244
Dentist (General Practice)
6735 FM 78, SUITE 106
SAN ANTONIO, TX 78244

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1770023624, enumerated as an "organization" on February 26, 2017.

The provider is located at 6735 FM 78 SUITE 103 SAN ANTONIO, TX 78244 and the phone number is (210) 888-9960.

Pediatrics with taxonomy code 208000000X.

The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Ambetter. Please consult your insurance carrier or call the provider to verify.