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General NPI Number Information
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NPI Number | 1528383908
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Entity Type | Individual
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Provider Name | NICOLE LAIRD MD
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Gender | Female
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Dates
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Enumeration Date | 03/29/2010
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Last Update Date | 07/10/2013
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Provider Practice Location Address
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Address Line | 1005 W RALPH HALL PKWY STE 135
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City | ROCKWALL
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State | TX
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Zip | 75032-6658
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Country | US
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Telephone | 972-772-3100
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Fax | 972-692-1128
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Provider Business Mailing Address
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Address Line | 1005 W RALPH HALL PKWY STE 135
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City | ROCKWALL
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State | TX
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Zip | 75032-6658
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Country | US
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Telephone | 972-772-3100
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Fax | 972-692-1128
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | P3750
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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