Individual
LAUREN WELBY BERRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-1000
(254) 724-2111
Mailing address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
110570
GA
207YS0123X
Facial Plastic Surgery Physician
110570
GA
208600000X
Surgery Physician
2020014729
MO
390200000X
Student in an Organized Health Care Education/Training Program
BP10074890
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2020014729
MO BOARD OF HEALING ARTS
MO
Enumeration date
06/05/2020
Last updated
05/13/2026
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