Provider Demographics
NPI:1720617210
Name:STRAZZULLA, RAYMOND LAWRENCE (PT, DPT)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:LAWRENCE
Last Name:STRAZZULLA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2650
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-8607
Mailing Address - Country:US
Mailing Address - Phone:972-724-2400
Mailing Address - Fax:972-724-2495
Practice Address - Street 1:4401 LONG PRAIRIE RD STE 300
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2008
Practice Address - Country:US
Practice Address - Phone:972-691-1331
Practice Address - Fax:972-691-1731
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1347949225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist