Organization
HARLINGEN INNOVATIVE REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELEONZETTA BONILLA M.S, CCC-SLP (SPEECH LANGUAGE PATHOLOGIST/OWNER)
(956) 440-0806
Entity
Organization
Contact information
Practice address
1021 S F ST, HARLINGEN, TX 78550-6748
(956) 440-0806
(956) 440-0856
Mailing address
1021 S F ST, HARLINGEN, TX 78550-6748
(956) 440-0806
(956) 440-0856
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
24779
TX
261QR0400X
Rehabilitation Clinic/Center
Primary
24779
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A6103
MEDICARE PTAN
TX
05
—
202804501
—
TX
Enumeration date
07/28/2009
Last updated
11/02/2010
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