Provider Demographics
NPI:1003197138
Name:PANOS, LAURA (MS, CGC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:PANOS
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3410 WORTH ST
Mailing Address - Street 2:SUITE 760
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-2003
Mailing Address - Country:US
Mailing Address - Phone:214-820-9600
Mailing Address - Fax:214-820-9606
Practice Address - Street 1:3410 WORTH ST
Practice Address - Street 2:SUITE 760
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2003
Practice Address - Country:US
Practice Address - Phone:214-402-2357
Practice Address - Fax:214-820-9606
Is Sole Proprietor?:No
Enumeration Date:2011-09-02
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS