Provider Demographics
NPI:1760676167
Name:FUN THERAPY, LLC
Entity Type:Organization
Organization Name:FUN THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CELIA
Authorized Official - Middle Name:T
Authorized Official - Last Name:OJEAGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-227-4200
Mailing Address - Street 1:7108 N. CYNTHIA ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504
Mailing Address - Country:US
Mailing Address - Phone:956-227-4200
Mailing Address - Fax:
Practice Address - Street 1:909 BUSINESS PARK DR
Practice Address - Street 2:SUITE B
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-6052
Practice Address - Country:US
Practice Address - Phone:956-227-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX658540000261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6584000OtherPHYSICAL THERAPY