Individual provider Active NPI

Laura Clede Tetheggen

  • Physical Medicine & Rehabilitation Physician
  • Brownsville, TX
National Provider Identifier
1336341007
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
1060085 Issued in TX
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

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
1060085TXMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.