Healthcare Provider Details

I. General information

NPI: 1407041916
Provider Name (Legal Business Name): AZIZ L LAURENT M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2007
Last Update Date: 09/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7551 METRO CENTER DR SUITE 200
AUSTIN TX
78744-1625
US

IV. Provider business mailing address

7551 METRO CENTER DR SUITE 200
AUSTIN TX
78744-1625
US

V. Phone/Fax

Practice location:
  • Phone: 512-326-3300
  • Fax:
Mailing address:
  • Phone: 512-326-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberH1795
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: