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Individual

DR. LAUREN NICOLE GANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1500 CITYWEST BLVD, STE. 300, HOUSTON, TX 77042-2300
(713) 620-4000
(713) 458-4229
Mailing address
PO BOX 650865, DALLAS, TX 75265-0865
(972) 233-1999
(972) 233-3666

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
BP10036717
TX
207L00000X
Anesthesiology Physician
Primary
Q0258
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
343131401
TX
01
8ER719
BCBS
TX
01
P01518481
RR MEDICARE
TX
Enumeration date
06/28/2010
Last updated
11/13/2020
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