Provider Demographics
NPI:1427218007
Name:SHEPARD, LAUREN COLEMAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:COLEMAN
Last Name:SHEPARD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28522 BLUE HOLLY LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-0633
Mailing Address - Country:US
Mailing Address - Phone:281-396-4266
Mailing Address - Fax:
Practice Address - Street 1:28522 BLUE HOLLY LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-0633
Practice Address - Country:US
Practice Address - Phone:281-396-4266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX240191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice