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Organization
FLY AWAY THERAPY CORP
Active
Organization
FLY AWAY THERAPY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LUPITA ALANIZ (CEO)
(956) 502-1333
Entity
Organization
Contact information
Practice address
917 E GARCIA CIR, PHARR, TX 78577-1822
(956) 502-1333
(866) 903-7799
Mailing address
357 PINE CRK, ALAMO, TX 78516-4701
(956) 502-1333
(866) 903-7799
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558669853
NATIONAL PROVIDER IDENTIFIER
TX
01
—
1669606000
NATIONAL PROVIDER IDENTIFIER
TX
Enumeration date
10/22/2019
Last updated
10/22/2019
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