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General NPI Number Information
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NPI Number | 1053951053
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Entity Type | Individual
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Provider Name | ELIZABETH O LAIRD ATC
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Gender | Female
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Dates
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Enumeration Date | 01/08/2020
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Last Update Date | 01/08/2020
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Provider Practice Location Address
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Address Line | 4550 US HIGHWAY 281
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City | BROWNSVILLE
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State | TX
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Zip | 78520-4020
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Country | US
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Telephone | 956-574-5671
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Fax |
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Provider Business Mailing Address
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Address Line | 3729 SUN COUNTRY DR
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City | HARLINGEN
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State | TX
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Zip | 78552-3913
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Country | US
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Telephone | 513-315-3928
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT4804
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License Number State | TX
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