Healthcare Provider Details

I. General information

NPI: 1063887867
Provider Name (Legal Business Name): LAUREN STILES D.P.T
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2015
Last Update Date: 11/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10526 W PARMER LN SUITE 403
AUSTIN TX
78717-5056
US

IV. Provider business mailing address

17325 BELL NORTH DR SUITE 2-B
SCHERTZ TX
78154-3368
US

V. Phone/Fax

Practice location:
  • Phone: 512-900-3302
  • Fax: 512-900-3321
Mailing address:
  • Phone: 888-590-4002
  • Fax: 210-590-4585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number039654
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1276401
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: