Provider Demographics
NPI:1538591821
Name:REGAN, LAURA SUZANNE (PA)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:SUZANNE
Last Name:REGAN
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:4351 BOOTH CALLOWAY RD
Mailing Address - Street 2:SUITE 308
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-7378
Mailing Address - Country:US
Mailing Address - Phone:817-595-3700
Mailing Address - Fax:817-595-3701
Practice Address - Street 1:4351 BOOTH CALLOWAY RD
Practice Address - Street 2:SUITE 308
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-7378
Practice Address - Country:US
Practice Address - Phone:817-595-3700
Practice Address - Fax:817-595-3701
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant