Provider Demographics
NPI:1003214511
Name:SONNENBURG, LAURA A (PA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:SONNENBURG
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:A
Other - Last Name:QUINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:4214 ANDREWS HWY STE 306
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79703-4870
Mailing Address - Country:US
Mailing Address - Phone:432-699-6000
Mailing Address - Fax:432-699-6012
Practice Address - Street 1:4214 ANDREWS HWY STE 306
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79703-4870
Practice Address - Country:US
Practice Address - Phone:432-699-6000
Practice Address - Fax:432-699-6012
Is Sole Proprietor?:No
Enumeration Date:2014-12-15
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA09556363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical