Provider Demographics
NPI:1134410517
Name:LAO, ALEXANDER DELA CRUZ (PT)
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:DELA CRUZ
Last Name:LAO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:705 WALTER REED BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-5726
Mailing Address - Country:US
Mailing Address - Phone:972-487-5570
Mailing Address - Fax:972-487-5098
Practice Address - Street 1:705 WALTER REED BLVD.
Practice Address - Street 2:SUITE 100
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042
Practice Address - Country:US
Practice Address - Phone:972-487-5570
Practice Address - Fax:972-487-5098
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1037398225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist