Provider Demographics
NPI:1760962872
Name:ADODO, LAURY I
Entity Type:Individual
Prefix:
First Name:LAURY
Middle Name:I
Last Name:ADODO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13718 SAN MARTIN LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-3450
Mailing Address - Country:US
Mailing Address - Phone:281-857-5053
Mailing Address - Fax:832-664-2018
Practice Address - Street 1:3315 MARQUART ST STE 209
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-6027
Practice Address - Country:US
Practice Address - Phone:713-799-2202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26619164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse