Provider Demographics
NPI:1457512675
Name:TORRES, LIBRADO (DC)
Entity Type:Individual
Prefix:DR
First Name:LIBRADO
Middle Name:
Last Name:TORRES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W BRONZE DR
Mailing Address - Street 2:APT D
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-8171
Mailing Address - Country:US
Mailing Address - Phone:956-358-8832
Mailing Address - Fax:
Practice Address - Street 1:2310 N EXPRESSWAY # 83
Practice Address - Street 2:STE. M
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-0903
Practice Address - Country:US
Practice Address - Phone:956-546-5000
Practice Address - Fax:956-546-6231
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10301111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OA6283OtherGROUP MEDICARE PIN
1457512675OtherNPI
1457512675OtherNPI