Provider Demographics
NPI:1003155201
Name:THERAGISTICS, LLC
Entity Type:Organization
Organization Name:THERAGISTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NORA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:956-240-4210
Mailing Address - Street 1:3025 HAWTHORNE AVE
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-3470
Mailing Address - Country:US
Mailing Address - Phone:956-240-4210
Mailing Address - Fax:956-287-4052
Practice Address - Street 1:3025 HAWTHORNE AVE
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-3470
Practice Address - Country:US
Practice Address - Phone:956-240-4210
Practice Address - Fax:956-287-4052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-07
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102580251E00000X
TX1081388251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX102850OtherSTATE BOARD FOR SPEECH LANGUAGE PATHOLOGY
TX1142057OtherSTATE BOARD OF PHYSICAL THERAPY