Provider Information for 1497528269
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LAURA CHRISTINE FAIAI
Sex: Female
NPI: 1497528269
Last Updated: 2023-11-03
Certification Date: 2023-11-03
Certification Date: 2023-11-03
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1497528269 | ||||||||
| Enumeration Date | 2023-11-03 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1231 NEWMAN AVE IOWA PARK, TX 76367-2752 United States Phone: 940-613-7180 | Fax: | ||||||||
| Primary Practice Address | 1231 NEWMAN AVE IOWA PARK, TX 76367-2752 United States Phone: 940-613-7180 | Fax: | ||||||||
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