Individual
MR. CRAIG LAURENTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.S.A.
Contact information
Practice address
3016 HONEY TREE LN, AUSTIN, TX 78746-6742
(512) 632-7561
(512) 328-7160
Mailing address
3016 HONEY TREE LN, AUSTIN, TX 78746-6742
(512) 632-7561
(512) 328-7160
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
SA00178
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21LF
BLUE CROSS BLUE SHIELD
TX
Enumeration date
04/12/2007
Last updated
07/08/2007
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