Provider Demographics
NPI:1134278476
Name:LAOS, CARLA MAGNOLIA (MD)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:MAGNOLIA
Last Name:LAOS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2020 MCCLENDON ST
Mailing Address - Street 2:UPPER
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2118
Mailing Address - Country:US
Mailing Address - Phone:214-926-6492
Mailing Address - Fax:
Practice Address - Street 1:6621 FANNIN ST STE A.210
Practice Address - Street 2:TEXAS CHILDREN'S HOSPITAL BCM C/O PEGGY WOMACK
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2303
Practice Address - Country:US
Practice Address - Phone:832-824-5628
Practice Address - Fax:832-825-5424
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2011-03-02
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Provider Licenses
StateLicense IDTaxonomies
TXN13672080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB116786Medicare PIN