Provider Demographics
NPI:1659676120
Name:CORE THERAPEUTICS, LLC
Entity type:Organization
Organization Name:CORE THERAPEUTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CORINA
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:956-451-8853
Mailing Address - Street 1:PO BOX 5321
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-5321
Mailing Address - Country:US
Mailing Address - Phone:956-687-9100
Mailing Address - Fax:956-687-9102
Practice Address - Street 1:6400 N 10TH ST
Practice Address - Street 2:STE. C
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3385
Practice Address - Country:US
Practice Address - Phone:956-687-9100
Practice Address - Fax:956-687-9102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-14
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID #