Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | L2463 | TX |
N | 207VE0102X | Reproductive Endocrinologist | L2463 | TX |
NPI | 1366473399 |
---|---|
Provider Name | Laurie Jane Mckenzie |
First Address | Houston, TX 77030-2353 |
Second Address | Houston, TX 77030-4000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 09/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
146950402 | (05) | TX |
146950405 | (05) | TX |
146950406 | CSHCN TPI (01) | TX |
8H3605 | BCBS (01) | TX |
H42406 | (02) | TX |