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Individual

MRS. LAURA MARIE PAVELKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP-C

Contact information

Practice address
630 N COIT RD, SUITE 2200, RICHARDSON, TX 75080-3700
(214) 389-7355
(214) 389-7435
Mailing address
3249 HEATHERBROOK LN, RICHARDSON, TX 75082-2695
(214) 621-2625
(214) 389-7435

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
693670
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
693670
NP LICENSE NUMBER
TX
Enumeration date
09/26/2006
Last updated
07/08/2007
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