Provider Demographics
NPI:1619146602
Name:HARDIN, LAURA ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ELIZABETH
Last Name:HARDIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:LAURIE
Other - Middle Name:ELIZABETH
Other - Last Name:HARDIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:23002 RED RIVER DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-3159
Mailing Address - Country:US
Mailing Address - Phone:281-744-7599
Mailing Address - Fax:
Practice Address - Street 1:18980 W MEMORIAL DR STE 300
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4559
Practice Address - Country:US
Practice Address - Phone:281-548-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2022-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05694363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical