Provider Demographics
NPI:1700210275
Name:LINO TORRES,JR L.L.C.
Entity Type:Organization
Organization Name:LINO TORRES,JR L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:LINO
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:JR
Authorized Official - Credentials:OTR
Authorized Official - Phone:956-982-8578
Mailing Address - Street 1:1091 W ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-6415
Mailing Address - Country:US
Mailing Address - Phone:956-982-8578
Mailing Address - Fax:956-982-8741
Practice Address - Street 1:2600 OLD ALICE RD
Practice Address - Street 2:SUITE C
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-1594
Practice Address - Country:US
Practice Address - Phone:956-982-8578
Practice Address - Fax:956-982-8741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-02
Last Update Date:2013-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110086225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX147484302Medicaid