Provider Demographics
NPI:1558719039
Name:BRETZ, LAUREN A (MD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:A
Last Name:BRETZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:17198 ST LUKES WAY STE 300
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-8014
Mailing Address - Country:US
Mailing Address - Phone:936-267-6300
Mailing Address - Fax:936-321-3271
Practice Address - Street 1:17198 ST LUKES WAY STE 630
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-8017
Practice Address - Country:US
Practice Address - Phone:936-267-6300
Practice Address - Fax:936-321-0883
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10057571208000000X
TXS1055208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics