Provider Demographics
NPI:1023127529
Name:AUSTIN, LAURA LOU ANN (PT)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LOU ANN
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:LOU ANN
Other - Last Name:TOSSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2501 N EASTMAN RD
Mailing Address - Street 2:APT. 200F
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-4022
Mailing Address - Country:US
Mailing Address - Phone:469-688-5271
Mailing Address - Fax:
Practice Address - Street 1:3206 N 4TH ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-5143
Practice Address - Country:US
Practice Address - Phone:903-753-6635
Practice Address - Fax:903-753-1114
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1163598225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist