Individual
LAURA E. PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2550 BOBCAT BLVD STE 100, TROPHY CLUB, TX 76262-5135
(817) 347-8100
(817) 347-8099
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-6483
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
Q7456
TX
Other
Enumeration date
04/23/2013
Last updated
01/19/2023
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