Provider Demographics
NPI:1417674953
Name:LAWHON, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:LAWHON
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 1:6401 WHISKERBRUSH RD
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-1819
Mailing Address - Country:US
Mailing Address - Phone:817-312-1071
Mailing Address - Fax:
Practice Address - Street 1:966 N GARDEN RIDGE BLVD STE 530
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-2876
Practice Address - Country:US
Practice Address - Phone:972-420-6605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1237806225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist