Individual
HAILEY ELIZABETH LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3600 GASTON AVE STE 550, DALLAS, TX 75246-1905
(214) 821-1177
Mailing address
12709 BURNINGLOG LN, DALLAS, TX 75243-3231
(972) 907-0087
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/08/2022
Last updated
02/23/2023
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