Provider Demographics
NPI:1053544486
Name:GLOVER, LAUREN AUDREY (PT, DPT, ATC, LAT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:AUDREY
Last Name:GLOVER
Suffix:
Gender:F
Credentials:PT, DPT, ATC, LAT
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:AUDREY
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1441 S MIDLOTHIAN PKWY STE 170
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-5597
Mailing Address - Country:US
Mailing Address - Phone:972-723-0380
Mailing Address - Fax:972-723-0276
Practice Address - Street 1:2851 MATLOCK RD
Practice Address - Street 2:#442
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-5037
Practice Address - Country:US
Practice Address - Phone:817-473-6246
Practice Address - Fax:817-473-2014
Is Sole Proprietor?:No
Enumeration Date:2009-09-02
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist