Provider Demographics
NPI:1417439753
Name:DAPDAP, LALAINE
Entity type:Individual
Prefix:
First Name:LALAINE
Middle Name:
Last Name:DAPDAP
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 1:12101 NORTHPOINTE BLVD APT 9110
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-2230
Mailing Address - Country:US
Mailing Address - Phone:432-448-5373
Mailing Address - Fax:
Practice Address - Street 1:5423 HAMILTON WOLFE RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4344
Practice Address - Country:US
Practice Address - Phone:210-694-9464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1212062225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist