Provider Demographics
NPI:1710048863
Name:PHYSIOCARE THERAPY, PC
Entity Type:Organization
Organization Name:PHYSIOCARE THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ONUWA
Authorized Official - Middle Name:D
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:LPT, DPT
Authorized Official - Phone:956-583-2995
Mailing Address - Street 1:1918 E GRIFFIN PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-3106
Mailing Address - Country:US
Mailing Address - Phone:956-583-2995
Mailing Address - Fax:956-583-3595
Practice Address - Street 1:407 W STATE HWY 495
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589
Practice Address - Country:US
Practice Address - Phone:956-583-2995
Practice Address - Fax:956-583-3595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy