Provider Demographics
NPI:1114970647
Name:SCOTT D. LAUER, DO PA
Entity Type:Organization
Organization Name:SCOTT D. LAUER, DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:D
Authorized Official - Last Name:LAUER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-296-4392
Mailing Address - Street 1:PO BOX 820577
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-0577
Mailing Address - Country:US
Mailing Address - Phone:817-506-8905
Mailing Address - Fax:
Practice Address - Street 1:729 W BEDFORD EULESS RD
Practice Address - Street 2:SUITE 106
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053-3939
Practice Address - Country:US
Practice Address - Phone:817-284-8222
Practice Address - Fax:817-595-5718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9102207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG89659Medicare UPIN