MEDICARE: LAURA JOYCE VAN DE LAAR 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	207Y00000X	Otolaryngology Physician	T1870	TX

General Provider Information

NPI Number	:	1588041180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA JOYCE VAN DE LAAR M.D.

Provider Business Mailing Address
First Line	:	1529 HEIGHTS BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-4218
Country	:	US
Telephone Number	:	281-748-5229
Fax Number	:

Provider Business Practice Location Address
First Line	:	1529 HEIGHTS BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-4218
Country	:	US
Telephone Number	:	281-748-5229
Fax Number	:

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

Provider Enumeration Date	:	05/03/2015
Last Update Date	:	06/25/2025

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