Provider Demographics
NPI:1801862032
Name:BARNES, LAURA E (OD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:E
Last Name:BARNES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 SABLE FLS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4870
Mailing Address - Country:US
Mailing Address - Phone:210-536-5781
Mailing Address - Fax:
Practice Address - Street 1:2200 BERGUIST DR SUITE 1
Practice Address - Street 2:ATTN CREDENTIALS (CMC)
Practice Address - City:LACKLAND AFB
Practice Address - State:TX
Practice Address - Zip Code:78236-5300
Practice Address - Country:US
Practice Address - Phone:210-536-5781
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2546T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist