Healthcare Provider Details

I. General information

NPI: 1730499609
Provider Name (Legal Business Name): LAURA A TRUAX PA-C, MPAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2010
Last Update Date: 06/30/2023
Certification Date: 06/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 E BELL RD STE 3200
PHOENIX AZ
85032-2162
US

IV. Provider business mailing address

3815 E BELL RD STE 2200
PHOENIX AZ
85032-2139
US

V. Phone/Fax

Practice location:
  • Phone: 602-494-5040
  • Fax: 602-494-9736
Mailing address:
  • Phone: 602-633-3848
  • Fax: 602-633-3841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number4725
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: