Basic Information
| Provider Information | |||||||||
| NPI: | 1578643979 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LESSARD | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | CHRISTINE | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6550 FANNIN ST | ||||||||
| Address2: | SUITE 1601 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134415141 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6550 FANNIN ST STE 1501 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770302743 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134415141 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2006 | ||||||||
| LastUpdateDate: | 01/29/2019 | ||||||||
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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 | 363L00000X | 642590 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | AP110379 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 208600000X | 642590 | TX | N | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 8375ND | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER | 143374005 | 05 | TX | MEDICAID | 143374003 | 05 | TX | MEDICAID | 8Y8958 | 01 | TX | BCBS | OTHER | 143374004 | 05 | TX | MEDICAID |