Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | J2805 | TX |
NPI | 1255330619 |
---|---|
Provider Name | Dr. Laura L Somerville |
First Address | Baytown, TX 77521-7721 |
Second Address | Baytown, TX 77521-7721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 26/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E16376 | (02) |