Individual
DR. EDWARD ARTHUR LAUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11801 SOUTH FREEWAY, BURLESON, TX 76028
(817) 568-5456
(817) 568-1296
Mailing address
11801 SOUTH FREEWAY, PO BOX 6337, FORT WORTH, TX 76115
(817) 568-5456
(817) 568-1296
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
K9101
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0022EJ
BLUE CROSS BLUE SHIELD
TX
01
—
029998402
SUPERIOR HEALTH CHIPS
TX
05
—
029998402
—
TX
01
—
930973104
HUMANA/MILITARY-TRICARE
TX
Enumeration date
11/23/2005
Last updated
10/19/2010
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