MEDICARE: LAURA MARIE ARNOLD DO

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207V00000X	Obstetrics & Gynecology Physician	Q1080	TX

General Provider Information

NPI Number	:	1689990251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA MARIE ARNOLD DO

Provider Business Mailing Address
First Line	:	2012 KINGSBROOK TRL
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76120-5078
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10840 TEXAS HEALTH TRL STE 270
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-6849
Country	:	US
Telephone Number	:	682-212-6437
Fax Number	:	682-212-9438

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

Provider Enumeration Date	:	04/07/2010
Last Update Date	:	09/09/2014

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