Basic Information
| Provider Information | |||||||||
| NPI: | 1982091765 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAUGH | ||||||||
| FirstName: | LAURA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 309 LUCILLE ST | ||||||||
| Address2: | |||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750604249 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2144126458 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2001 N OREGON ST | ||||||||
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| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799023320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9155776011 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2015 | ||||||||
| LastUpdateDate: | 07/12/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207ZP0102X | T1003 | TX | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.