Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | H9254 | TX |
N | 2081P2900X | Pain Medicine | H9254 | TX |
NPI | 1366445579 |
---|---|
Provider Name | Laura K. Prewitt-Buchanan |
First Address | Dripping Springs, TX 78620-3908 |
Second Address | Dripping Springs, TX 78620-3908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 17/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
116998904 | (05) | TX |
F01610 | (02) |