Provider Demographics
NPI:1265645253
Name:BUCK, LAUREN ASHLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ASHLEY
Last Name:BUCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6750 N MACARTHUR BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-2517
Mailing Address - Country:US
Mailing Address - Phone:469-283-1217
Mailing Address - Fax:
Practice Address - Street 1:6750 N MACARTHUR BLVD STE 160
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-2517
Practice Address - Country:US
Practice Address - Phone:469-283-1217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS22405208600000X
LAMD.207196208600000X
TXQ4052208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery