Provider Demographics
NPI:1093308884
Name:LANG, CAITLIN
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:LANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 TRIPP RD STE 150
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-5703
Mailing Address - Country:US
Mailing Address - Phone:972-681-6460
Mailing Address - Fax:972-681-6475
Practice Address - Street 1:909 TRIPP RD STE 150
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-5703
Practice Address - Country:US
Practice Address - Phone:972-681-6460
Practice Address - Fax:972-681-6475
Is Sole Proprietor?:No
Enumeration Date:2021-02-12
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1343785225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist