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NPI Code Detail

MEDICARE: ELITE THERAPEUTIC SPECIALISTS, LTD.

MEDICARE: ELITE THERAPEUTIC SPECIALISTS, LTD.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QH0700XHearing and Speech Clinic/Center
2261QP2000XPhysical Therapy Clinic/Center
3261QR0400XRehabilitation Clinic/Center
4261QM1300XMulti-Specialty Clinic/Center
5261Q00000XClinic/Center

General Provider Information

NPI Number : 1154600716
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELITE THERAPEUTIC SPECIALISTS, LTD.
Provider Business Mailing Address
First Line : 1020 CORPUS CHRISTI ST
Second Line :
City : LAREDO
State : TX
Zip : 78040-5208
Country : US
Telephone Number : 956-723-5700
Fax Number : 956-723-5706
Provider Business Practice Location Address
First Line : 1020 CORPUS CHRISTI ST
Second Line :
City : LAREDO
State : TX
Zip : 78040-5208
Country : US
Telephone Number : 956-723-5700
Fax Number : 956-723-5706
Authorized Official
Title or Position : OWNER/ADMINISTRATOR
Name : MRS. ELISA SUSANNA DRUKER
Credential : MA,CCC-SLP
Telephone Number : 956-723-5700
Provider Enumeration Date : 08/12/2011
Last Update Date : 08/23/2011

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Directions to “ELITE THERAPEUTIC SPECIALISTS, LTD. ” Practice Location

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