Laurel Dupont, PT

Individual provider Active NPI Physical Therapist · Grapevine, TX

NPI 1124070081 · NPPES record last updated Feb 19, 2009

Key facts

NPI
1124070081
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
04557 (LA)
Practice address
1217 Ira E Woods Ave
Grapevine, TX 76051-4023
Phone
(817) 481-8585
Fax
(817) 488-8282
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
04557LAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
NSR Louisiana, LLC Past
since Sep 6, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 04557 LA Yes

Addresses

Primary practice location

1217 Ira E Woods Ave
Grapevine, TX 76051-4023

Mailing address

1217 Ira E Woods Ave
Grapevine, TX 76051-4023
Phone (817) 481-8585

Other providers in Grapevine, TX

All providers in Grapevine, TX · Physical Therapist in Texas

Sources for this page

Verify at the official NPI Registry.