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General NPI Number Information
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NPI Number | 1376848689
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Entity Type | Individual
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Provider Name | LAURA BETH SHAO PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/18/2011
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 1201 MAGNOLIA CT STE 109
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City | MOORE
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State | OK
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Zip | 73160-1433
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Country | US
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Telephone | 405-759-4155
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Fax | 855-538-3095
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Provider Business Mailing Address
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Address Line | PO BOX 720094
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City | NORMAN
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State | OK
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Zip | 73070-4072
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Country | US
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Telephone | 405-620-2870
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Fax | 855-538-3095
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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 | 1955
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License Number State | OK
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