Provider Demographics
NPI:1427218643
Name:JONES, LARA BRETT (PA-C)
Entity Type:Individual
Prefix:
First Name:LARA
Middle Name:BRETT
Last Name:JONES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LARA
Other - Middle Name:BRETT
Other - Last Name:ERMALINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:16659 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 235
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2375
Mailing Address - Country:US
Mailing Address - Phone:281-980-2717
Mailing Address - Fax:
Practice Address - Street 1:16659 SOUTHWEST FWY
Practice Address - Street 2:SUITE 235
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2375
Practice Address - Country:US
Practice Address - Phone:281-980-2717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02967363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical