Individual
LARA PAVAGEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6200 W PARKER RD, PLANO, TX 75093-8185
(972) 981-8000
Mailing address
1121 E SPRING CREEK PKWY., STE. 110, #319, PLANO, TX 75074
(214) 343-6663
(214) 343-2814
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
T0599
TX
208M00000X
Hospitalist Physician
T0599
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
428205501
—
TX
Enumeration date
05/13/2015
Last updated
08/25/2024
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