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General NPI Number Information
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NPI Number | 1003155201
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Entity Type | Organization
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Legal Business Name | THERAGISTICS, LLC
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Dates
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Enumeration Date | 02/07/2013
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Last Update Date | 02/12/2013
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Provider Practice Location Address
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Address Line | 3025 HAWTHORNE AVE
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City | EDINBURG
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State | TX
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Zip | 78539-3470
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Country | US
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Telephone | 956-240-4210
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Fax | 956-287-4052
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Provider Business Mailing Address
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Address Line | 3025 HAWTHORNE AVE
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City | EDINBURG
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State | TX
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Zip | 78539-3470
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Country | US
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Telephone | 956-240-4210
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Fax | 956-287-4052
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | NORA MOLINA
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Credential | SLP
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Telephone | 956-240-4210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1081388
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 102580
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License Number State | TX
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