Healthcare Provider Details

I. General information

NPI: 1629228861
Provider Name (Legal Business Name): PERFORMANCE THERAPEUTICS-ELSA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2008
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 RETAMA ST STE E
ELSA TX
78543-3004
US

IV. Provider business mailing address

2101 N 23RD ST
MCALLEN TX
78501-6127
US

V. Phone/Fax

Practice location:
  • Phone: 956-262-9131
  • Fax: 956-262-9232
Mailing address:
  • Phone: 956-687-4559
  • Fax: 956-618-1342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1139541
License Number StateTX

VIII. Authorized Official

Name: OMAR PALOMIN
Title or Position: OWNER/ PHYSICAL THERAPIST
Credential: P.T.
Phone: 956-687-4559