Provider Demographics
NPI:1629291802
Name:NAYLOR, LAUREN BROOKE (MD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:BROOKE
Last Name:NAYLOR
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 1:2821 MICHAEL ANGELO
Mailing Address - Street 2:SUITE 102
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-1404
Mailing Address - Country:US
Mailing Address - Phone:956-686-6100
Mailing Address - Fax:956-686-6115
Practice Address - Street 1:2821 MICHAEL ANGELO
Practice Address - Street 2:SUITE 102
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-1404
Practice Address - Country:US
Practice Address - Phone:956-686-6100
Practice Address - Fax:956-686-6115
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8859208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164758802Medicaid