MEDICARE: FIRST CLASS THERAPY CENTER LLC

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
1	261QR0400X	Rehabilitation Clinic/Center		TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982987202
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST CLASS THERAPY CENTER LLC

Provider Business Mailing Address
First Line	:	709 S RAUL LONGORIA RD
Second Line	:	STE G
City	:	EDINBURG
State	:	TX
Zip	:	78542-5238
Country	:	US
Telephone Number	:	956-381-4545
Fax Number	:	956-381-4541

Provider Business Practice Location Address
First Line	:	709 S RAUL LONGORIA RD
Second Line	:	STE G
City	:	EDINBURG
State	:	TX
Zip	:	78542-5238
Country	:	US
Telephone Number	:	956-381-4545
Fax Number	:	956-381-4541

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARY MONTEMAYOR
Credential	:	OTA
Telephone Number	:	956-381-4545

Provider Enumeration Date	:	09/22/2011
Last Update Date	:	09/22/2011

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Directions to “FIRST CLASS THERAPY CENTER LLC ” Practice Location

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