Provider Demographics
NPI:1063944049
Name:ROWE, LAURA POINDEXTER (DPM)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:POINDEXTER
Last Name:ROWE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:JEAN
Other - Last Name:POINDEXTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:6145 N THESTA ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5266
Mailing Address - Country:US
Mailing Address - Phone:559-436-4820
Mailing Address - Fax:559-436-4821
Practice Address - Street 1:6145 N THESTA ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5266
Practice Address - Country:US
Practice Address - Phone:559-436-4820
Practice Address - Fax:559-436-4821
Is Sole Proprietor?:No
Enumeration Date:2017-03-30
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAE5651213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program