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NPI Code Detail

MEDICARE: LAURA FONSECA MD

MEDICARE:   LAURA  FONSECA  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
1207VX0000XObstetrics PhysicianS1398TX
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1861879447
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA FONSECA MD
Provider Business Mailing Address
First Line : 4217 NORTH MCCOLL RD STE 700
Second Line :
City : MCALLEN
State : TX
Zip : 78504-4466
Country : US
Telephone Number : 956-627-0817
Fax Number : 956-627-0975
Provider Business Practice Location Address
First Line : 4217 NORTH MCCOLL RD STE 700
Second Line :
City : MCALLEN
State : TX
Zip : 78504-4466
Country : US
Telephone Number : 956-627-0817
Fax Number : 956-627-0975
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2015
Last Update Date : 05/14/2020

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Directions to “ LAURA FONSECA MD” Practice Location

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