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General NPI Number Information
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NPI Number | 1558670901
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Entity Type | Organization
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Legal Business Name | KENNETH J LAURORA MD PA
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Dates
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Enumeration Date | 10/04/2010
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Last Update Date | 01/14/2015
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Provider Practice Location Address
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Address Line | 400 BYPASS LN STE 111
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City | LIVINGSTON
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State | TX
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Zip | 77351-7380
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Country | US
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Telephone | 936-327-1020
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Fax | 936-327-1022
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Provider Business Mailing Address
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Address Line | 400 BYPASS LN STE 111
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City | LIVINGSTON
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State | TX
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Zip | 77351-7380
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Country | US
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Telephone | 936-327-1020
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Fax | 936-327-1022
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Authorized Official
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Title or Position | PRESIDENT
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Name | KENNETH J LAURORA
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Credential | MD
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Telephone | 936-327-1020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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