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General NPI Number Information
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NPI Number | 1528400314
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Entity Type | Organization
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Legal Business Name | C.O.R.E. PEDIATRIC THERAPY
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Dates
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Enumeration Date | 07/23/2013
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Last Update Date | 07/23/2013
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Provider Practice Location Address
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Address Line | 14914 HONEY LN # A
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City | HOUSTON
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State | TX
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Zip | 77085-4063
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Country | US
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Telephone | 281-866-5186
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Fax | 832-598-2161
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Provider Business Mailing Address
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Address Line | 14914 HONEY LN # A
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City | HOUSTON
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State | TX
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Zip | 77085-4063
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Country | US
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Telephone | 281-866-5186
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Fax | 832-598-2161
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. SERGIO SALAZAR
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Credential |
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Telephone | 281-866-1295
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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 |
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License Number State |
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