Individual
LAUREN N BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4801 TROUP HWY, SUITE 800, TYLER, TX 75703-2356
(903) 939-2800
Mailing address
2162 RANA PARK, FLINT, TX 75762-8840
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
110902
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149984001
—
TX
Enumeration date
06/24/2010
Last updated
06/24/2010
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