MEDICARE: DR. AUDREY TURNER LACOUR M.D.

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	207Q00000X	Family Medicine Physician	M1862	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8DB548	OTHER	TX	BCBS OF TX

General Provider Information

NPI Number	:	1437190774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUDREY TURNER LACOUR M.D.

Provider Business Mailing Address
First Line	:	10555 PEARLAND PKWY STE W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77089-2676
Country	:	US
Telephone Number	:	713-991-7100
Fax Number	:	713-991-7103

Provider Business Practice Location Address
First Line	:	10555 PEARLAND PKWY STE W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77089-2676
Country	:	US
Telephone Number	:	713-991-7100
Fax Number	:	713-991-7103

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	01/27/2023

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