MEDICARE: LAUREN BROOKE SHAW PT, DPT

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

General Provider Information

NPI Number	:	1881550028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN BROOKE SHAW PT, DPT

Provider Business Mailing Address
First Line	:	1203 TIANA ST
Second Line	:
City	:	ANNA
State	:	TX
Zip	:	75409-1248
Country	:	US
Telephone Number	:	936-239-8632
Fax Number	:

Provider Business Practice Location Address
First Line	:	2960 ELDORADO PKWY STE 75
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-7500
Country	:	US
Telephone Number	:	972-562-0713
Fax Number	:

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

Provider Enumeration Date	:	12/31/2025
Last Update Date	:	12/31/2025

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