Provider Demographics
NPI:1851117956
Name:SERES, LOREN ELIZABETH (LMT)
Entity type:Individual
Prefix:
First Name:LOREN
Middle Name:ELIZABETH
Last Name:SERES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1374 SANDPIPER DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-3818
Mailing Address - Country:US
Mailing Address - Phone:662-630-0877
Mailing Address - Fax:
Practice Address - Street 1:2101 AIRLINE RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-2641
Practice Address - Country:US
Practice Address - Phone:662-992-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-23
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT142490225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist