Provider Demographics
NPI:1700551041
Name:CORE REHAB PT LLC
Entity Type:Organization
Organization Name:CORE REHAB PT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:G
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:956-328-0811
Mailing Address - Street 1:3516 MORRIS ST
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542-4574
Mailing Address - Country:US
Mailing Address - Phone:956-328-0811
Mailing Address - Fax:
Practice Address - Street 1:3516 MORRIS ST
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78542-4574
Practice Address - Country:US
Practice Address - Phone:956-328-0811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty