Individual
DR. ANNA L LAVEDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1601 W HEBRON PARKWAY, STE 100, CARROLLTON, TX 75010
(972) 426-8675
(972) 492-4694
Mailing address
1601 W HEBRON PKWY STE 100, CARROLLTON, TX 75010-6342
(972) 426-8675
(972) 492-4694
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
20249
NE
207R00000X
Internal Medicine Physician
Primary
P6014
TX
208000000X
Pediatrics Physician
P6014
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
339109601
MEDICAID - OTHER
TX
Enumeration date
05/24/2006
Last updated
10/31/2019
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