Provider Demographics
NPI:1750861381
Name:BARCO, LAURA TOMASA (PTA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:TOMASA
Last Name:BARCO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1887
Mailing Address - Street 2:
Mailing Address - City:ELSA
Mailing Address - State:TX
Mailing Address - Zip Code:78543-1887
Mailing Address - Country:US
Mailing Address - Phone:956-355-6971
Mailing Address - Fax:
Practice Address - Street 1:1208 S BRIDGE AVE
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-7906
Practice Address - Country:US
Practice Address - Phone:956-969-3130
Practice Address - Fax:956-969-3138
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225200000X
TX2060038225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant