Provider Demographics
NPI:1326283243
Name:PAWELEK, LAUREL JOY (PT)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:JOY
Last Name:PAWELEK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LAUREL
Other - Middle Name:JOY
Other - Last Name:GOLDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2301 HUNTER RD
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-5106
Mailing Address - Country:US
Mailing Address - Phone:512-753-5868
Mailing Address - Fax:512-753-5855
Practice Address - Street 1:2301 HUNTER RD
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-5106
Practice Address - Country:US
Practice Address - Phone:512-753-5868
Practice Address - Fax:512-753-5855
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1118149225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist