Provider Demographics
NPI:1922605682
Name:LAZO, CATHERINE (DPT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:LAZO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2511 GOLF COURSE RD APT 527
Mailing Address - Street 2:
Mailing Address - City:KINGSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78363-2905
Mailing Address - Country:US
Mailing Address - Phone:214-625-2198
Mailing Address - Fax:
Practice Address - Street 1:138 S FM 1329
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:TX
Practice Address - Zip Code:78384-3925
Practice Address - Country:US
Practice Address - Phone:361-279-8291
Practice Address - Fax:361-279-7219
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1337865225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist