Provider Demographics
NPI:1316277965
Name:THERAPEDI LLC
Entity type:Organization
Organization Name:THERAPEDI LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SOSA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MPT
Authorized Official - Phone:956-455-0717
Mailing Address - Street 1:PO BOX 720166
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-0166
Mailing Address - Country:US
Mailing Address - Phone:956-455-0717
Mailing Address - Fax:956-618-0899
Practice Address - Street 1:3200 N 23RD ST STE 1
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-6058
Practice Address - Country:US
Practice Address - Phone:956-455-0717
Practice Address - Fax:956-827-5244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-04
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
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
TXPENDINGMedicaid