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NPI Code Detail

MEDICARE: LAURA ELIZABETH PICHA PT, DPT

MEDICARE: LAURA ELIZABETH PICHA PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1194043TX

General Provider Information

NPI Number : 1417276148
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA ELIZABETH PICHA PT, DPT
Provider Business Mailing Address
First Line : 5026 DEEPWOOD CIR
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78415-2901
Country : US
Telephone Number : 361-241-7399
Fax Number : 361-241-7464
Provider Business Practice Location Address
First Line : 4040 FIVE POINTS RD
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78410-4538
Country : US
Telephone Number : 361-241-7399
Fax Number : 361-241-7464
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2010
Last Update Date : 04/24/2014

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