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Individual
LAURA L MCDONOUGH
Active
Individual
LAURA L MCDONOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01102
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
298658001
—
TX
01
—
8N3085
BCBS
TX
Enumeration date
10/27/2005
Last updated
06/19/2023
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