Provider Demographics
NPI:1154178994
Name:ESPINOSA, LAURA MARIA
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:MARIA
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 MICHOACAN LOOP
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-6641
Mailing Address - Country:US
Mailing Address - Phone:956-740-1817
Mailing Address - Fax:
Practice Address - Street 1:9803 STERLING LOOP UNIT 190
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-6442
Practice Address - Country:US
Practice Address - Phone:956-726-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2040004225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant