Provider Demographics
NPI:1659307254
Name:JORKY INC.
Entity Type:Organization
Organization Name:JORKY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YBARRA
Authorized Official - Suffix:
Authorized Official - Credentials:LVN,BSHCS
Authorized Official - Phone:956-585-2439
Mailing Address - Street 1:1904 EAST GRIFFIN PARKWAY
Mailing Address - Street 2:STE A
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-3106
Mailing Address - Country:US
Mailing Address - Phone:956-585-2439
Mailing Address - Fax:956-585-3145
Practice Address - Street 1:1904 E GRIFFIN PKWY STE A
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3106
Practice Address - Country:US
Practice Address - Phone:956-585-2439
Practice Address - Fax:956-585-3145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1739435-02Medicaid
TX173943501Medicaid
TX454864Medicare UPIN