Provider Demographics
NPI:1144589045
Name:SOOS, LAURA JOAN (MED, MS)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:JOAN
Last Name:SOOS
Suffix:
Gender:F
Credentials:MED, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 SCENIC DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-7725
Mailing Address - Country:US
Mailing Address - Phone:512-863-9511
Mailing Address - Fax:512-869-1400
Practice Address - Street 1:2001 SCENIC DR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-7725
Practice Address - Country:US
Practice Address - Phone:512-863-9511
Practice Address - Fax:512-869-1400
Is Sole Proprietor?:No
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105943235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist