Kenneth J Laurora Md Pa | |
400 Bypass Ln Ste 111 Livingston TX 77351-7380 | |
(936) 327-1020 | |
(936) 327-1022 |
Full Name | Kenneth J Laurora Md Pa |
---|---|
Speciality | Internal Medicine |
Location | 400 Bypass Ln Ste 111, Livingston, Texas |
Authorized Official Name and Position | Kenneth J Laurora (PRESIDENT) |
Authorized Official Contact | 9363271020 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Kenneth J Laurora Md Pa 400 Bypass Ln Ste 111 Livingston TX 77351-7380 Ph: (936) 327-1020 | Kenneth J Laurora Md Pa 400 Bypass Ln Ste 111 Livingston TX 77351-7380 Ph: (936) 327-1020 |
NPI Number | 1558670901 |
---|---|
Provider Enumeration Date | 10/04/2010 |
Last Update Date | 01/14/2015 |
Medicare PECOS PAC ID | 2567644198 |
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Medicare Enrollment ID | O20110303000213 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558670901 | NPI | - | NPPES |
296647501 | Medicaid | TX | |
158661202 | Medicaid | TX | |
296647502 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Kenneth J Laurora |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1184606378 PECOS PAC ID: 7517861313 Enrollment ID: I20031124000185 |
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