Provider Demographics
NPI:1326421173
Name:COSTA THERAPY INSTITUTE, LLC
Entity Type:Organization
Organization Name:COSTA THERAPY INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SELVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-465-7756
Mailing Address - Street 1:7308 DOMINICA DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-4036
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:956-982-8741
Practice Address - Street 1:2740 W ALTON GLOOR BLVD STE A
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-4476
Practice Address - Country:US
Practice Address - Phone:956-982-8578
Practice Address - Fax:956-982-8741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-29
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)Group - Multi-Specialty