Healthcare Provider Details

I. General information

NPI: 1487225587
Provider Name (Legal Business Name): LAURA RAYBURN DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2021
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 SCHOFIELD RD
FORT SAM HOUSTON TX
78234-7577
US

IV. Provider business mailing address

18310 EDWARDS BLF
SAN ANTONIO TX
78259-3547
US

V. Phone/Fax

Practice location:
  • Phone: 210-916-3000
  • Fax:
Mailing address:
  • Phone: 210-996-1136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number1046955
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: