Provider Demographics
NPI:1164792354
Name:THERASSIST REHAB SERVICES, LLC
Entity Type:Organization
Organization Name:THERASSIST REHAB SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA PAZ-REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-455-9898
Mailing Address - Street 1:604 S JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-2356
Mailing Address - Country:US
Mailing Address - Phone:956-289-1716
Mailing Address - Fax:956-289-1737
Practice Address - Street 1:604 S JACKSON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-2356
Practice Address - Country:US
Practice Address - Phone:956-289-1716
Practice Address - Fax:956-289-1737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104407235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty