Basic Information
| Provider Information | |||||||||
| NPI: | 1841269263 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LATORRE | ||||||||
| FirstName: | JUAN | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3000 N IH 35 STE 660 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787051851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122361310 | ||||||||
| FaxNumber: | 5122366963 | ||||||||
| Practice Location | |||||||||
| Address1: | 919 E 32ND ST | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787052703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5125447111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2006 | ||||||||
| LastUpdateDate: | 01/04/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2081P0004X | L5802 | TX | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Spinal Cord Injury Medicine | 208100000X | L5802 | TX | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.