MEDICARE: DR. ANNA O LAVROVA MD

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	207R00000X	Internal Medicine Physician	V1524	TX

General Provider Information

NPI Number	:	1275169377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNA O LAVROVA MD

Provider Business Mailing Address
First Line	:	21309 FOSTER RD STE 100
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-4209
Country	:	US
Telephone Number	:	281-587-1700
Fax Number	:

Provider Business Practice Location Address
First Line	:	21309 FOSTER RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-4209
Country	:	US
Telephone Number	:	281-587-1700
Fax Number	:

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

Provider Enumeration Date	:	03/20/2020
Last Update Date	:	08/13/2024

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