| NPI | 1154793040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH MODESTO Administrator 956-572-1908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 104389) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 112112) |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: TX 1158203) | |
| Enumeration Date | 2015-10-30 |
| Last Update Date | 2018-07-16 |