MEDICARE: BAYSIDE THERAPY ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	224Z00000X	Occupational Therapy Assistant
2	225200000X	Physical Therapy Assistant
3	225X00000X	Occupational Therapist
4	235Z00000X	Speech-Language Pathologist
5	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1255033080
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYSIDE THERAPY ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	3813 PRISCILLA DR
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-5629
Country	:	US
Telephone Number	:	361-537-1790
Fax Number	:

Provider Business Practice Location Address
First Line	:	3813 PRISCILLA DR
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-5629
Country	:	US
Telephone Number	:	361-537-1790
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	DR. GUILE GARZA RIVERA
Credential	:	PT, DPT
Telephone Number	:	361-510-0915

Provider Enumeration Date	:	03/17/2023
Last Update Date	:	03/17/2023

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