Healthcare Provider Details

I. General information

NPI: 1972719540
Provider Name (Legal Business Name): PATRICK J LAURINI DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: PATRICK J LAURINI DC

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 10/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2376 LAVON DR
GARLAND TX
75040-9037
US

IV. Provider business mailing address

PO BOX 851195
RICHARDSON TX
75085-1195
US

V. Phone/Fax

Practice location:
  • Phone: 469-569-8413
  • Fax: 972-664-0449
Mailing address:
  • Phone: 469-569-8413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number5905
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: