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Individual
LAURA PACEK
Active
Individual
LAURA PACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01213
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
285135404
—
TX
01
—
346885YK7Y
MEDICARE PTAN
TX
01
—
PA01213
PA LIC
TX
Enumeration date
06/15/2006
Last updated
09/29/2021
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