Provider Demographics
NPI:1457555062
Name:DURAN, LAURA PATRICIA (PT)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:PATRICIA
Last Name:DURAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 W BUCHANAN ST STE C
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-6617
Mailing Address - Country:US
Mailing Address - Phone:956-277-0401
Mailing Address - Fax:956-277-0467
Practice Address - Street 1:622 W BUCHANAN ST STE C
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-6617
Practice Address - Country:US
Practice Address - Phone:956-277-0401
Practice Address - Fax:956-277-0467
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1086908225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX063093102Medicaid