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General NPI Number Information
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NPI Number | 1053085878
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Entity Type | Individual
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Provider Name | LAUREN WATSON OD
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Gender | Female
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Dates
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Enumeration Date | 08/04/2021
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 10925 BALTIMORE AVE
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City | BELTSVILLE
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State | MD
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Zip | 20705-2117
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Country | US
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Telephone | 301-595-9041
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Fax |
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Provider Business Mailing Address
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Address Line | 9105 LAKE LARGO DR
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City | UPPER MARLBORO
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State | MD
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Zip | 20774-4726
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Country | US
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Telephone | 443-955-8317
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5494
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TA2846
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License Number State | MD
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