Provider Demographics
NPI:1801163555
Name:LAUMBACH-KIRK, ANGEL (MOTR/L)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:LAUMBACH-KIRK
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15304 COUNTY ROAD 2160
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-7935
Mailing Address - Country:US
Mailing Address - Phone:806-223-6688
Mailing Address - Fax:
Practice Address - Street 1:15304 COUNTY ROAD 2160
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423
Practice Address - Country:US
Practice Address - Phone:806-223-6688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2038225X00000X
TX110895225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist