Organization
BLUEBONNET SURGICAL ASSOCIATES, P,A,
Active
Other names
Laurel Humphrey, M.D.,P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAUREL L HUMPHREY POWELL M.D. (PRESIDENT)
(972) 283-9900
Entity
Organization
Contact information
Practice address
3430 W WHEATLAND RD, SUITE 407, DALLAS, TX 75237-3446
(972) 283-9900
(972) 283-9905
Mailing address
3430 W WHEATLAND RD, SUITE 407, DALLAS, TX 75237-3446
(972) 283-9900
(972) 283-9905
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M1773
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184272601
—
TX
Enumeration date
06/27/2008
Last updated
05/11/2011
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