Provider Demographics
NPI:1528958667
Name:BRANUM, LAURA (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:BRANUM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-5059
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 W 4TH ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-5059
Practice Address - Country:US
Practice Address - Phone:432-640-1189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX575241835E0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835E0208XPharmacy Service ProvidersPharmacistEmergency Medicine