Provider Demographics
NPI:1437487741
Name:GORA, DELIA YVONNE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:DELIA
Middle Name:YVONNE
Last Name:GORA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 BUDDY OWENS AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6446
Mailing Address - Country:US
Mailing Address - Phone:956-631-6200
Mailing Address - Fax:956-631-1117
Practice Address - Street 1:3601 BUDDY OWENS AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6446
Practice Address - Country:US
Practice Address - Phone:956-631-6200
Practice Address - Fax:956-631-1117
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107880225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX107880OtherLISCENCE NUMBER