Provider Demographics
NPI:1679977839
Name:LAWRENCE, LAURA (NP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8222 DOUGLAS AVE STE 600
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5937
Mailing Address - Country:US
Mailing Address - Phone:972-993-5040
Mailing Address - Fax:972-993-5041
Practice Address - Street 1:8222 DOUGLAS AVE STE 600
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5937
Practice Address - Country:US
Practice Address - Phone:972-993-5040
Practice Address - Fax:972-993-5041
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126604363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX381962YKP5Medicare PIN
TX381962YKQLMedicare PIN