Provider Demographics
NPI:1912047093
Name:THERAPY CONSULTANTS OF LAREDO
Entity Type:Organization
Organization Name:THERAPY CONSULTANTS OF LAREDO
Other - Org Name:KIDS THERAPY CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:INFANTE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:956-251-3254
Mailing Address - Street 1:1605 E HILLSIDE RD
Mailing Address - Street 2:STE 3
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-3399
Mailing Address - Country:US
Mailing Address - Phone:956-722-4444
Mailing Address - Fax:
Practice Address - Street 1:1605 E HILLSIDE RD
Practice Address - Street 2:3
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-3399
Practice Address - Country:US
Practice Address - Phone:956-722-4444
Practice Address - Fax:956-796-1117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX156653225100000X
TX105936225X00000X
TX15187235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX742643906OtherTAX ID