Provider Demographics
NPI:1285698068
Name:URBEN, LARRY P (MS ATC LAT C PED)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:P
Last Name:URBEN
Suffix:
Gender:M
Credentials:MS ATC LAT C PED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6100 CARLTON CT
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-8789
Mailing Address - Country:US
Mailing Address - Phone:214-725-6988
Mailing Address - Fax:972-767-3017
Practice Address - Street 1:6842 LEBANON RD
Practice Address - Street 2:SUITE 104
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-7478
Practice Address - Country:US
Practice Address - Phone:972-913-6684
Practice Address - Fax:972-767-3017
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3204225000000X
TXAT30242255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter