Individual
DR. LAURA JENNIFER HAYGOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
455 RICE ROAD, STE. 104, TYLER, TX 75703-3604
(903) 597-3376
(903) 526-7703
Mailing address
455 RICE ROAD, STE. 104, TYLER, TX 75703-3604
(903) 597-3376
(903) 526-7703
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
K3905
TX
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
K3905
TX
207NP0225X
Pediatric Dermatology Physician
K3905
TX
207NS0135X
Procedural Dermatology Physician
K3905
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0082DN
BCBS
TX
Enumeration date
05/16/2007
Last updated
08/12/2015
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