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Individual

LAURA E. AUSBROOKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WHCNP

Contact information

Practice address
5201 HARRY HINES BLVD, WISH TUBAL CLINIC, DALLAS, TX 75235-7708
(214) 590-5306
(214) 590-2798
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
593438
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
163686201
TX
05
163686202
TX
05
163686203
TX
05
163686204
TX
05
163686205
TX
05
163686206
TX
05
163686207
TX
05
163686208
TX
05
163686209
TX
05
163686210
TX
05
163686211
TX
01
8N4872
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/28/2005
Last updated
05/13/2009
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