Individual
MAGEN LEA LASKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6606 LBJ FWY STE 200, DALLAS, TX 75240-6524
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 650865, DALLAS, TX 75265-0865
(972) 715-5000
(972) 715-9976
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
770507
TX
367500000X
Certified Registered Nurse Anesthetist
770507
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP124993
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
331435303
—
TX
01
—
BCBS TX
8748UG
TX
Enumeration date
12/20/2013
Last updated
03/25/2016
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