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Individual
LAUREN DOUGLAS
Active
Individual
LAUREN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558645333
NPI-HEARNE CHC
TX
01
—
1821185299
FQHC-BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC. - AGENCY NPI
TX
01
—
2872434-01
FQHC FACILITY TPI (HEARNE CHC)
TX
01
—
74-1715140
BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.
TX
Enumeration date
03/12/2009
Last updated
01/07/2021
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