Healthcare Provider Details

I. General information

NPI: 1336543602
Provider Name (Legal Business Name): LAURA B RAMSOWER CP, LP, COA, LOA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2014
Last Update Date: 10/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 W BEN WHITE BLVD STE 162
AUSTIN TX
78704-7679
US

IV. Provider business mailing address

8800B SHOAL CREEK BLVD
AUSTIN TX
78757-6818
US

V. Phone/Fax

Practice location:
  • Phone: 512-371-1700
  • Fax: 512-912-9618
Mailing address:
  • Phone: 512-371-1700
  • Fax: 512-371-1754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number1440
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: