Provider Demographics
NPI:1528400314
Name:C.O.R.E. PEDIATRIC THERAPY
Entity Type:Organization
Organization Name:C.O.R.E. PEDIATRIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-866-1295
Mailing Address - Street 1:14914 HONEY LN # A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77085-4063
Mailing Address - Country:US
Mailing Address - Phone:281-866-5186
Mailing Address - Fax:832-598-2161
Practice Address - Street 1:14914 HONEY LN # A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77085-4063
Practice Address - Country:US
Practice Address - Phone:281-866-5186
Practice Address - Fax:832-598-2161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health