Provider Demographics
NPI:1780619031
Name:ELSA THERAPY & WELLNESS CENTER, INC.
Entity type:Organization
Organization Name:ELSA THERAPY & WELLNESS CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:956-461-2309
Mailing Address - Street 1:PO BOX 1769
Mailing Address - Street 2:
Mailing Address - City:ELSA
Mailing Address - State:TX
Mailing Address - Zip Code:78543
Mailing Address - Country:US
Mailing Address - Phone:956-262-1037
Mailing Address - Fax:956-262-7756
Practice Address - Street 1:908 W. EDINBURG AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ELSA
Practice Address - State:TX
Practice Address - Zip Code:78543
Practice Address - Country:US
Practice Address - Phone:956-262-1037
Practice Address - Fax:956-262-7756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37129104100000X
TX208752224Z00000X
TX1131290225100000X
TX110383225X00000X
TX115122355S0801X
TX2064523225200000X
TX112802225X00000X
TX340092355S0801X
TX347392355S0801X
TX102929235Z00000X
TXM2376261QM2500X
TXK8596261QM2500X
TX341952355S0801X
TX123902355S0801X
TX261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)Group - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141479OtherSUPERIOR HEALTH PLAN
TX1834772-02Medicaid
TX660900000OtherPHYSICAL THERAPY FACILITY
TX0009PGOtherBLUE CROSS & BLUE SHIELD
TX1834772-03Medicaid
TX555000000OtherOCCUPATIONAL THERAPY FACI
TX555000000OtherOCCUPATIONAL THERAPY FACI