Organization
LAURA PARK, CRNA, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CECE J PANNELL (OFFICE MANAGER)
(817) 294-7444
Entity
Organization
Contact information
Practice address
6405 W PARKER RD, PLANO, TX 75093-8179
(972) 473-9292
Mailing address
PO BOX 11219, FORT WORTH, TX 76110-0219
(817) 294-7444
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
653370
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C70T
BCBSTX
TX
Enumeration date
06/18/2008
Last updated
10/18/2012
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