Provider Demographics
NPI:1245461631
Name:LARRINAGA, IRIS (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:IRIS
Middle Name:
Last Name:LARRINAGA
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9441 LBJ FWY STE 101
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-4566
Mailing Address - Country:US
Mailing Address - Phone:908-358-5157
Mailing Address - Fax:
Practice Address - Street 1:9441 LBJ FWY STE 101
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-4566
Practice Address - Country:US
Practice Address - Phone:908-358-5157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1044576225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist