Healthcare Provider Details

I. General information

NPI: 1982964789
Provider Name (Legal Business Name): THERAPLAY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2012
Last Update Date: 05/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 W BLUE JAY AVE
PHARR TX
78577-8898
US

IV. Provider business mailing address

808 W BLUE JAY AVE
PHARR TX
78577-8898
US

V. Phone/Fax

Practice location:
  • Phone: 956-784-0662
  • Fax: 956-683-9329
Mailing address:
  • Phone: 956-784-0662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: SYLVIA LIZETTE HERNANDEZ
Title or Position: ONWER
Credential: OTR
Phone: 956-784-0662