Active NPI
Laura Clede Tetheggen
- Physical Medicine & Rehabilitation Physician
- Brownsville, TX
National Provider Identifier
1336341007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 1060085
- Practice address
- 1901 E 22ND St
Brownsville, TX 78521-2956 - Phone
- (956) 542-8504
- Fax
- (956) 542-6510
- NPI assigned
- Jun 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 1060085 | TX | Primary |
Addresses
Primary practice location
1901 E 22ND St
Brownsville, TX 78521-2956
Mailing address
1901 E 22ND St
Brownsville, TX 78521-2956
Phone (956) 542-8504
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1060085 | TX | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brownsville Society for Crippled Children Inc | Past | Accepting new patients | |
| Utmb Faculty Group Practice | Past | Accepting new patients |
Organizations & group practices 2
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.
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- NPI 1942241146
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336341007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1901 E 22ND ST",
"city": "BROWNSVILLE",
"state": "TX",
"postal_code": "785212956",
"telephone_number": "956-542-8504",
"fax_number": "956-542-6510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 E 22ND ST",
"city": "BROWNSVILLE",
"state": "TX",
"postal_code": "785212956",
"telephone_number": "956-542-8504",
"fax_number": "956-542-6510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TETHEGGEN",
"first_name": "LAURA",
"middle_name": "CLEDE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "TX",
"license": "1060085",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brownsville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.