Basic Information
| Provider Information | |||||||||
| NPI: | 1730685421 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUDSON | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | E | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 S LOOP 336 W | ||||||||
| Address2: | |||||||||
| City: | CONROE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773043302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9365394500 | ||||||||
| FaxNumber: | 9365394050 | ||||||||
| Practice Location | |||||||||
| Address1: | 129 VISION PARK BLVD STE 110 | ||||||||
| Address2: | |||||||||
| City: | SHENANDOAH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773843024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9365394500 | ||||||||
| FaxNumber: | 9365394050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2018 | ||||||||
| LastUpdateDate: | 10/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | U0130 | TX | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.