MEDICARE: BARBARA LATHAM P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1116465	TX

General Provider Information

NPI Number	:	1124365952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA LATHAM P.T.

Provider Business Mailing Address
First Line	:	5900 SOUTHWEST PKWY
Second Line	:	SUITE 420
City	:	AUSTIN
State	:	TX
Zip	:	78735-6202
Country	:	US
Telephone Number	:	512-914-1773
Fax Number	:

Provider Business Practice Location Address
First Line	:	5900 SOUTHWEST PKWY
Second Line	:	SUITE 420
City	:	AUSTIN
State	:	TX
Zip	:	78735-6202
Country	:	US
Telephone Number	:	512-326-4191
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2013
Last Update Date	:	02/28/2017

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