Provider Demographics
NPI:1467948992
Name:FUNCTIONAL GAINZ THERAPY CENTER LLC
Entity Type:Organization
Organization Name:FUNCTIONAL GAINZ THERAPY CENTER LLC
Other - Org Name:RIO GRANDE THERAPEUTIC INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER/ALTERNATE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTELLANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-647-5363
Mailing Address - Street 1:502 W SUGARCANE DR
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78599-3831
Mailing Address - Country:US
Mailing Address - Phone:956-647-5363
Mailing Address - Fax:956-647-5393
Practice Address - Street 1:502 W SUGARCANE DR
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78599
Practice Address - Country:US
Practice Address - Phone:956-647-5363
Practice Address - Fax:956-647-5393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-09
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation