Provider Demographics
NPI:1538182191
Name:DEWYER, LAURA L (APRN,BC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:DEWYER
Suffix:
Gender:F
Credentials:APRN,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 W BAY AREA BLVD
Mailing Address - Street 2:#500
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4043
Mailing Address - Country:US
Mailing Address - Phone:281-554-2200
Mailing Address - Fax:281-554-4340
Practice Address - Street 1:711 W BAY AREA BLVD
Practice Address - Street 2:#500
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4043
Practice Address - Country:US
Practice Address - Phone:281-554-2200
Practice Address - Fax:281-554-4340
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX649994363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily