| Organization Name: | THERAPY LANE PEDIATRIC REHABILITATION |
| NPI Number: | 1003130667 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELIZABETH DENISE CLOSNER (OWNER/SPEECH LANGUAGE PATHOLOGIST) |
| Mailing Address: | 2110 Lomas Del Sur Ste. 114 Laredo |
| State: | TX US |
| Postal Code: | 780465750 |
| Phone Number: | 9567297555 |
| Fax Number: | 9567297886 |
| NPI Enumeration Date: | 03/24/2010 |
| NPI Last Update Date: | 03/09/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | 103450 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |