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General NPI Number Information
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NPI Number | 1841269263
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Entity Type | Individual
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Provider Name | JUAN M. LATORRE M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 01/04/2022
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Provider Practice Location Address
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Address Line | 919 E 32ND ST
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City | AUSTIN
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State | TX
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Zip | 78705-2703
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Country | US
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Telephone | 512-544-7111
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 N IH 35 STE 660
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City | AUSTIN
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State | TX
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Zip | 78705-1851
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Country | US
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Telephone | 512-236-1310
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Fax | 512-236-6963
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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 | 2081P0004X
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Taxonomy Name | Spinal Cord Injury Medicine Physician
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License Number | L5802
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | L5802
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License Number State | TX
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