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NPI Code Detail

MEDICARE: DR. JUAN M. LATORRE M.D.

MEDICARE: DR. JUAN M. LATORRE M.D.
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
12081P0004XSpinal Cord Injury Medicine PhysicianL5802TX
2208100000XPhysical Medicine & Rehabilitation PhysicianL5802TX

General Provider Information

NPI Number : 1841269263
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUAN M. LATORRE M.D.
Provider Business Mailing Address
First Line : 3000 N IH 35 STE 660
Second Line :
City : AUSTIN
State : TX
Zip : 78705-1851
Country : US
Telephone Number : 512-236-1310
Fax Number : 512-236-6963
Provider Business Practice Location Address
First Line : 919 E 32ND ST
Second Line :
City : AUSTIN
State : TX
Zip : 78705-2703
Country : US
Telephone Number : 512-544-7111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2006
Last Update Date : 01/04/2022

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