Laser Rehabilitation Clinic

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

LASER REHABILITATION CLINIC

Practice address

3212 Concord Drive
Suite E
Orange, TX 77630

Phone

(409) 882-0696

Fax

(409) 882-0427

NPI assigned

Jan 19, 2007

Last updated

Jul 22, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Janice S Earl, LILT AND BCHIS

Title

Owner Operator

Phone

(409) 882-0696

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1902959422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3212 CONCORD DRIVE",
            "address_2": "SUITE E",
            "city": "ORANGE",
            "state": "TX",
            "postal_code": "77630",
            "telephone_number": "409-882-0696",
            "fax_number": "409-882-0427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3212 CONCORD DRIVE",
            "address_2": "SUITE E",
            "city": "ORANGE",
            "state": "TX",
            "postal_code": "77630",
            "telephone_number": "409-882-0696",
            "fax_number": "409-882-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASER REHABILITATION CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "EARL",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER OPERATOR",
        "authorized_official_telephone_number": "409-882-0696",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LILT AND BCHIS"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022433901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEARING AID SPECIALIST",
            "identifier": "50306",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kroger Texas L P (Kroger Pharmacy)
• Keith Weston Kyle, D.D.S.
• Laboratory Corporation of America
• Steven L. Lackey, LPC-S
• Walter E Landisch, DDS
• Gary Leblanc, RPH
• Legacy
• Nina P Scales Leifeste, DDS
• Leonides Medrano, MD,PA
• Little Cypress-Maruiceville Isd

• Rehabilitation Clinic/Center in Orange, TX
• Providers in Orange, TX by specialty
• Rehabilitation Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.