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General NPI Number Information
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NPI Number | 1659676120
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Entity Type | Organization
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Legal Business Name | CORE THERAPEUTICS, LLC
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Dates
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Enumeration Date | 01/14/2011
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 6400 N 10TH ST STE. C
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City | MCALLEN
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State | TX
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Zip | 78504-3385
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Country | US
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Telephone | 956-687-9100
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Fax | 956-687-9102
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Provider Business Mailing Address
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Address Line | PO BOX 5321
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City | MCALLEN
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State | TX
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Zip | 78502-5321
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Country | US
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Telephone | 956-687-9100
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Fax | 956-687-9102
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Authorized Official
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Title or Position | OWNER
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Name | CORINA SUZANNE GONZALEZ
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Credential | OTR
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Telephone | 956-451-8853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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