Provider Demographics
NPI:1275864084
Name:VAVRIN, KAREN (LPT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:VAVRIN
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:DOENGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPT
Mailing Address - Street 1:2225 E RANDOL MILL RD
Mailing Address - Street 2:101
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-6315
Mailing Address - Country:US
Mailing Address - Phone:817-274-1200
Mailing Address - Fax:817-274-1299
Practice Address - Street 1:2225 E RANDOL MILL RD
Practice Address - Street 2:101
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-6315
Practice Address - Country:US
Practice Address - Phone:817-274-1200
Practice Address - Fax:817-274-1299
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-18
Last Update Date:2010-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1024099225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist