Provider Demographics
NPI:1164450771
Name:THERA-CARE REHAB SERVICES, PLLC
Entity Type:Organization
Organization Name:THERA-CARE REHAB SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNIE MARIE
Authorized Official - Middle Name:CASTILLO
Authorized Official - Last Name:ESGUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:956-227-2110
Mailing Address - Street 1:2504 E GRIFFIN PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-3348
Mailing Address - Country:US
Mailing Address - Phone:956-519-2700
Mailing Address - Fax:956-519-2704
Practice Address - Street 1:7600 W EXPRESSWAY 83 STE 4&5
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-2063
Practice Address - Country:US
Practice Address - Phone:956-581-7171
Practice Address - Fax:956-581-7178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7056829OtherAETNA
TX161766402Medicaid
TX0093LKOtherBCBS
TX676560Medicare ID - Type UnspecifiedOPT/ORF