Provider Demographics
NPI:1831865393
Name:LA PALOMA THERAPEUTICS PLLC
Entity type:Organization
Organization Name:LA PALOMA THERAPEUTICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:LIZETTE
Authorized Official - Last Name:REBOLLAR
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC-SLP
Authorized Official - Phone:956-784-2504
Mailing Address - Street 1:1209 E JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-6163
Mailing Address - Country:US
Mailing Address - Phone:956-784-2504
Mailing Address - Fax:
Practice Address - Street 1:4307 N 10TH ST STE G2
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3058
Practice Address - Country:US
Practice Address - Phone:956-626-0544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty