Provider Demographics
NPI:1649534306
Name:SEIFERT, LAURA KATHERINE (PT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:KATHERINE
Last Name:SEIFERT
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 1:11806 DOONESBURY CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-3804
Mailing Address - Country:US
Mailing Address - Phone:714-280-3518
Mailing Address - Fax:
Practice Address - Street 1:13740 RESEARCH BLVD
Practice Address - Street 2:SUITE V3
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1884
Practice Address - Country:US
Practice Address - Phone:714-280-3518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1222219225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist