# MYLAUREL MEDICAL GROUP TX, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932728946
- **Authorized official:** LESLIE BALDRIDGE (CREDENTIALING)
- **Authorized official phone:** (702) 417-6255

## Contact information

- **Practice address:** 2500 WEST LOOP S STE 230, HOUSTON, TX 77027-4512
- **Practice address phone:** (866) 603-7803
- **Mailing address:** 885 3RD AVE FL 29, NEW YORK, NY 10022-4834
- **Mailing address phone:** (347) 497-2452

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/09/2020
- **Last updated:** 11/04/2025