Provider Demographics
NPI:1841682317
Name:CALVERT, LAURA (PTA)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:CALVERT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MRS
Other - First Name:LAURA
Other - Middle Name:CALVERT
Other - Last Name:ZIPPRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:2103 LOU ELLEN LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-6010
Mailing Address - Country:US
Mailing Address - Phone:713-269-5240
Mailing Address - Fax:
Practice Address - Street 1:2103 LOU ELLEN LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-6010
Practice Address - Country:US
Practice Address - Phone:713-269-5240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2064099225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant