Basic Information
| Provider Information | |||||||||
| NPI: | 1962133017 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOMELI | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | ARLEN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8306 COUNTRY CLUB DR | ||||||||
| Address2: | |||||||||
| City: | LAREDO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 780452081 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9562363615 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5129 N GARLAND AVE STE 700 | ||||||||
| Address2: | |||||||||
| City: | GARLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750402746 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9722765191 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2022 | ||||||||
| LastUpdateDate: | 06/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 38538 | TX | N | Dental Providers | Dentist | General Practice | 122300000X | 38538 | TX | Y | Dental Providers | Dentist |
No ID Information.