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Organization

DEMING PEDIATRICS PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAURA M DEMING PNP (OWNER)
(361) 553-6844
Entity
Organization

Contact information

Practice address
1300 N VIRGINIA ST, SUITE 111, PORT LAVACA, TX 77979-2509
(361) 553-6844
(361) 553-7314
Mailing address
1300 N VIRGINIA ST, SUITE 111, PORT LAVACA, TX 77979-2509
(361) 553-6844
(361) 553-7314

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
587712
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1969230-02
TX
05
1969230-03
TX
Enumeration date
06/17/2010
Last updated
06/17/2010
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