Provider Demographics
NPI: | 1407353931 |
---|---|
Name: | KNIGHT, LAUREN LEIGH (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | LAUREN |
Middle Name: | LEIGH |
Last Name: | KNIGHT |
Suffix: | |
Gender: | F |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | PO BOX 840026 |
Mailing Address - Street 2: | |
Mailing Address - City: | DALLAS |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75284-0026 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 806-212-5079 |
Mailing Address - Fax: | 806-212-6278 |
Practice Address - Street 1: | 1600 WALLACE BLVD |
Practice Address - Street 2: | |
Practice Address - City: | AMARILLO |
Practice Address - State: | TX |
Practice Address - Zip Code: | 79106-1799 |
Practice Address - Country: | US |
Practice Address - Phone: | 806-212-2129 |
Practice Address - Fax: | 806-212-2246 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2018-04-11 |
Last Update Date: | 2025-08-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | S7259 | 208M00000X, 207Q00000X, 208M00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Multi-Specialty | |
Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
TX | 416832003 | Medicaid | |
TX | 1Q8749 | Other | MEDICARE PTAN |