Provider Demographics
NPI:1891990768
Name:LAHAYE, WILLIAM HEARNE (PT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:HEARNE
Last Name:LAHAYE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 SANTA ISABEL BLVD
Mailing Address - Street 2:# O2
Mailing Address - City:LAGUNA VISTA
Mailing Address - State:TX
Mailing Address - Zip Code:78578-2607
Mailing Address - Country:US
Mailing Address - Phone:956-943-5049
Mailing Address - Fax:
Practice Address - Street 1:100 E ALTON GLOOR BLVD STE A
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-3354
Practice Address - Country:US
Practice Address - Phone:956-350-7325
Practice Address - Fax:956-350-7330
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1142123225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist