Provider Demographics
NPI:1366486672
Name:CHOI, LAURA (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:CHOI
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 1:4201 GARTH RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-3167
Mailing Address - Country:US
Mailing Address - Phone:832-556-6046
Mailing Address - Fax:281-428-4750
Practice Address - Street 1:4201 GARTH RD
Practice Address - Street 2:SUITE 303
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3167
Practice Address - Country:US
Practice Address - Phone:832-556-6046
Practice Address - Fax:281-428-4750
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT042264208600000X
TXR0209208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8GG890OtherBCBS
CTP3459244OtherOXFORD
CT1422641Medicaid
NY2671896OtherNYS MEDICAID
TX365246301Medicaid
CT2414856OtherUNITED HEALTHCARE
CTP3459244OtherOXFORD
TX538548ZSWDMedicare PIN