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NPI Code Detail

MEDICARE: DR. LAURA LAGO LOPEZ-CONCEPCION M.D.

MEDICARE: DR. LAURA LAGO LOPEZ-CONCEPCION 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
1207R00000XInternal Medicine PhysicianM4306TX

General Provider Information

NPI Number : 1841390655
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAURA LAGO LOPEZ-CONCEPCION M.D.
Provider Business Mailing Address
First Line : 2802 WEBBERVILLE RD
Second Line :
City : AUSTIN
State : TX
Zip : 78702-2947
Country : US
Telephone Number : 512-972-4792
Fax Number :
Provider Business Practice Location Address
First Line : 2802 WEBBERVILLE RD
Second Line :
City : AUSTIN
State : TX
Zip : 78702-2947
Country : US
Telephone Number : 512-972-4792
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 03/10/2008

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