Provider Demographics
NPI:1609115666
Name:LEROY, LAUREN C (DC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:C
Last Name:LEROY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27646 COMMERCE OAKS DR
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE NORTH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-4404
Mailing Address - Country:US
Mailing Address - Phone:920-279-7701
Mailing Address - Fax:
Practice Address - Street 1:27646 COMMERCE OAKS DR
Practice Address - Street 2:
Practice Address - City:OAK RIDGE NORTH
Practice Address - State:TX
Practice Address - Zip Code:77385-4404
Practice Address - Country:US
Practice Address - Phone:920-279-7701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12190111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor