Provider Demographics
NPI:1700229606
Name:FURGALA, LAUREN (CNIM)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:FURGALA
Suffix:
Gender:F
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 592442
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-0172
Mailing Address - Country:US
Mailing Address - Phone:210-566-2333
Mailing Address - Fax:210-566-1330
Practice Address - Street 1:524 EXCHANGE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-2116
Practice Address - Country:US
Practice Address - Phone:210-566-2333
Practice Address - Fax:210-566-1330
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2464246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic