Healthcare Provider Details

I. General information

NPI: 1245816362
Provider Name (Legal Business Name): LAUREN WHITNEY HUFF PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2021
Last Update Date: 03/19/2021
Certification Date: 03/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3166 CLARKSVILLE ST
PARIS TX
75460-8015
US

IV. Provider business mailing address

3166 CLARKSVILLE ST
PARIS TX
75460-8015
US

V. Phone/Fax

Practice location:
  • Phone: 903-784-7702
  • Fax: 903-784-7703
Mailing address:
  • Phone: 903-784-7702
  • Fax: 903-784-7703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2144476
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: