Individual
MRS. LAURA MARCELA FREDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
536 SILICON DR STE 102, SOUTHLAKE, TX 76092-9020
(817) 203-4179
(817) 259-2793
Mailing address
1017 LA SALLE LN, SOUTHLAKE, TX 76092-1368
(646) 808-9186
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
0101278966
VA
2084P0800X
Psychiatry Physician
325225
NY
2084P0800X
Psychiatry Physician
Primary
V0394
TX
Other
Enumeration date
05/11/2018
Last updated
04/19/2024
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