Individual
DR. LAURIE G KILBOURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
132 E HOSPITAL DR, ANGLETON, TX 77515-4112
(979) 848-9143
Mailing address
PO BOX 650802, DALLAS, TX 75265-0802
(972) 715-5000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
J0845
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
098921203
—
TX
01
—
8CN283
BCBS
TX
01
—
J0845
TEXAS LICENSE
TX
01
—
P00355124
UNSPECIFIED RAILROAD MEDICARE
TX
Enumeration date
07/09/2006
Last updated
05/24/2011
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