MEDICARE: LAURA BOLLINGER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	39800	TX
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1154020188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA BOLLINGER

Provider Business Mailing Address
First Line	:	8210 FLOYD CURL DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3923
Country	:	US
Telephone Number	:	832-454-6868
Fax Number	:

Provider Business Practice Location Address
First Line	:	3135 RILEY FUZZEL RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-2810
Country	:	US
Telephone Number	:	281-363-0500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2023
Last Update Date	:	01/22/2026

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Directions to “ LAURA BOLLINGER ” Practice Location

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