Provider Demographics
NPI:1972961894
Name:MINDS AT PLAY PLLC
Entity Type:Organization
Organization Name:MINDS AT PLAY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTR/ADMIN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAOLA
Authorized Official - Middle Name:JANETH
Authorized Official - Last Name:VILLA
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:956-458-3970
Mailing Address - Street 1:701 N INTERNATIONAL BLVD
Mailing Address - Street 2:STE 101-1606
Mailing Address - City:HIDALGO
Mailing Address - State:TX
Mailing Address - Zip Code:78557-2582
Mailing Address - Country:US
Mailing Address - Phone:956-458-3970
Mailing Address - Fax:956-232-3856
Practice Address - Street 1:1001 S 10TH ST STE 2
Practice Address - Street 2:STE 3060
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-5049
Practice Address - Country:US
Practice Address - Phone:956-458-3970
Practice Address - Fax:956-232-3856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-05
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113264225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty