Provider Demographics
NPI:1780418376
Name:ROLLANS, LAUREN D (PTA)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:D
Last Name:ROLLANS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7109 GEORGEANN DR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78239-3363
Mailing Address - Country:US
Mailing Address - Phone:830-931-4594
Mailing Address - Fax:
Practice Address - Street 1:8522 BROADWAY STE 111
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-6377
Practice Address - Country:US
Practice Address - Phone:210-293-3111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2154689225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant