Individual
LAUREN LESAK CARAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2903 1ST AVE, LAKE CHARLES, LA 70601-8809
(337) 478-6480
(337) 474-9637
Mailing address
2903 1ST AVE, LAKE CHARLES, LA 70601-8809
(337) 478-6480
(337) 474-9637
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
200554
LA
363A00000X
Physician Assistant
PA06525
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
307406401
—
TX
01
—
875N30
BC/BS #
TX
01
—
8CF454
BCBSTX PROV. #
TX
01
—
P00852590
RAILROAD MEDICARE
TX
Enumeration date
12/30/2009
Last updated
08/27/2013
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