=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831055383
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THRIVE OT CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/29/2025
-----------------------------------------------------
Last Update Date | 12/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 211 S MAYBERRY RD
-----------------------------------------------------
City | MISSION
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78572-5755
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-648-3667
-----------------------------------------------------
Fax | 956-513-0366
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13930 N 38TH LN
-----------------------------------------------------
City | EDINBURG
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78541-4419
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-648-3667
-----------------------------------------------------
Fax | 956-513-0366
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | MR. RICARDO MORENO JR.
-----------------------------------------------------
Credential | COTA
-----------------------------------------------------
Telephone | 956-648-3667
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------