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General NPI Number Information
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NPI Number | 1013393669
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Entity Type | Individual
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Provider Name | LAUREN HARR PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/06/2015
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Last Update Date | 05/22/2018
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Provider Practice Location Address
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Address Line | 1622 8TH AVE STE 100
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City | FORT WORTH
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State | TX
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Zip | 76104
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Country | US
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Telephone | 817-927-2332
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Fax | 817-927-0361
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Provider Business Mailing Address
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Address Line | 706 W CENTER ST
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City | DUNCANVILLE
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State | TX
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Zip | 75116-4568
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Country | US
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Telephone | 972-780-0707
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA09898
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License Number State | TX
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