Individual
DOUGLAS I LAIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
700 SCOTT AND WHITE DR, COLLEGE STATION, TX 77845-6441
(979) 207-0100
(979) 207-2161
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
PA02267
TX
363A00000X
Physician Assistant
02267
TX
363A00000X
Physician Assistant
Primary
PA02267
TX
Other
Enumeration date
06/16/2006
Last updated
09/29/2020
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