| Organization Name: | LAREDO SPORTS MEDICINE CLINIC |
| NPI Number: | 1477675163 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN V PUIG (OWNER) |
| Mailing Address: | 9652 Mcpherson Rd Suite 12 Laredo |
| State: | TX US |
| Postal Code: | 780456565 |
| Phone Number: | 9567272122 |
| Fax Number: | 9567274445 |
| NPI Enumeration Date: | 04/04/2007 |
| NPI Last Update Date: | 01/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |