Provider Demographics
NPI:1780077339
Name:CORE ABILITY THERAPY
Entity type:Organization
Organization Name:CORE ABILITY THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:512-645-0768
Mailing Address - Street 1:8863 ANDERSON MILL RD
Mailing Address - Street 2:117
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-4600
Mailing Address - Country:US
Mailing Address - Phone:512-645-0768
Mailing Address - Fax:888-380-2633
Practice Address - Street 1:8863 ANDERSON MILL RD
Practice Address - Street 2:117
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-4600
Practice Address - Country:US
Practice Address - Phone:512-645-0768
Practice Address - Fax:888-380-2633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104285235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty