Provider Demographics
NPI:1215011515
Name:ACCENT THERAPY PROVIDER, PLLC
Entity Type:Organization
Organization Name:ACCENT THERAPY PROVIDER, PLLC
Other - Org Name:ACCENT THERAPY PROVIDER, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NORMITA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATAG
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:956-618-2287
Mailing Address - Street 1:4004 N JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-4962
Mailing Address - Country:US
Mailing Address - Phone:956-618-2287
Mailing Address - Fax:956-618-2296
Practice Address - Street 1:4004 N JACKSON RD
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-4962
Practice Address - Country:US
Practice Address - Phone:956-618-2287
Practice Address - Fax:956-618-2296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1073666261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX169365701Medicaid
TX1073666Medicare UPIN
TX676581Medicare PIN