Provider Demographics
NPI:1760171847
Name:RUNDALL, LAUREN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:RUNDALL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 CHELSEA BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-6248
Mailing Address - Country:US
Mailing Address - Phone:832-515-7612
Mailing Address - Fax:
Practice Address - Street 1:10125 KATY FWY STE 108
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1287
Practice Address - Country:US
Practice Address - Phone:800-447-3422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1296105225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist