Individual
LAURA FERNANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
920 MEDICAL PLAZA DR, SUITE 520, SHENANDOAH, TX 77380-3260
(832) 562-3974
(832) 813-0233
Mailing address
920 MEDICAL PLAZA DR, SUITE 520, SHENANDOAH, TX 77380-3260
(832) 562-3974
(832) 813-0233
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
K7017
TX
207RI0011X
Interventional Cardiology Physician
Primary
K7017
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8CC568
BLUE CROSS & BLUE SHIELD OF TEXAS
TX
Enumeration date
10/05/2006
Last updated
05/13/2019
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