Provider Demographics
NPI:1972719540
Name:LAURINI, PATRICK J (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:J
Last Name:LAURINI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:PATRICK
Other - Middle Name:J
Other - Last Name:LAURINI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 851195
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75085-1195
Mailing Address - Country:US
Mailing Address - Phone:469-569-8413
Mailing Address - Fax:
Practice Address - Street 1:2376 LAVON DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-9037
Practice Address - Country:US
Practice Address - Phone:469-569-8413
Practice Address - Fax:972-664-0449
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5905111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605051400OtherDEPT. OF LABOR
TX608603Medicare ID - Type Unspecified