Basic Information
| Provider Information | |||||||||
| NPI: | 1578526786 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAIDLEY | ||||||||
| FirstName: | ALISON | ||||||||
| MiddleName: | LISA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 911230 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753911230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729978000 | ||||||||
| FaxNumber: | 9722342987 | ||||||||
| Practice Location | |||||||||
| Address1: | 7777 FOREST LN STE C614 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752306856 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725667499 | ||||||||
| FaxNumber: | 9725666428 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2006 | ||||||||
| LastUpdateDate: | 01/18/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | J2651 | TX | N | Other Service Providers | Specialist | 208600000X | J2651 | TX | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 1578526786 | 01 | TX | RAILROAD MEDICARE | OTHER | P00811136 | 01 | TX | RAILROAD MEDICARE | OTHER | 098875003 | 05 | TX | MEDICAID |