Provider Demographics
NPI:1801823869
Name:TEXAS CORF INC
Entity Type:Organization
Organization Name:TEXAS CORF INC
Other - Org Name:LIFE SKILLS THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-373-0232
Mailing Address - Street 1:PO BOX 1900
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78599-1900
Mailing Address - Country:US
Mailing Address - Phone:956-783-8813
Mailing Address - Fax:956-783-8842
Practice Address - Street 1:427 E DURANTA AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:ALAMO
Practice Address - State:TX
Practice Address - Zip Code:78516-3406
Practice Address - Country:US
Practice Address - Phone:956-783-8813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2008-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX454848261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173056601Medicaid
TX173056601Medicaid