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General NPI Number Information
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NPI Number | 1518283175
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Entity Type | Individual
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Provider Name | LAURA L CRAFTON M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/07/2010
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Last Update Date | 09/01/2024
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Provider Practice Location Address
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Address Line | 4055 VALLEY VIEW LN
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City | DALLAS
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State | TX
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Zip | 75244-5074
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Country | US
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Telephone | 855-984-5121
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Fax |
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Provider Business Mailing Address
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Address Line | 612 DAVIES RD
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City | INEZ
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State | TX
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Zip | 77968-4342
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Country | US
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Telephone | 337-263-6879
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | J9152
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | J9152
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License Number State | TX
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