Provider Demographics
NPI:1598547309
Name:THRIVE THERAPY OF TEXAS
Entity Type:Organization
Organization Name:THRIVE THERAPY OF TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ SLP
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:MANRIQUEZ
Authorized Official - Last Name:LUJAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:432-661-5405
Mailing Address - Street 1:4010 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79765-2233
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3944 RANCH ROAD 620 S
Practice Address - Street 2:BUILDING 8, STE 206
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78738-7000
Practice Address - Country:US
Practice Address - Phone:512-645-8009
Practice Address - Fax:887-788-7260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty