Individual
LAURA WAYMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2300 E 30TH ST STE B-102, FARMINGTON, NM 87401-8991
(505) 609-6790
(505) 599-4640
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD2014-0243
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
63283786
—
NM
Enumeration date
03/31/2010
Last updated
11/14/2024
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