Provider Demographics
NPI:1952306482
Name:ROBLEDO, LAURA (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:ROBLEDO
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 1:10090 RUSHING RD STE B
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79924-3803
Mailing Address - Country:US
Mailing Address - Phone:915-248-1793
Mailing Address - Fax:915-225-3745
Practice Address - Street 1:10090 RUSHING RD STE B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79924-3803
Practice Address - Country:US
Practice Address - Phone:915-248-1793
Practice Address - Fax:915-225-3745
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2001-295208D00000X
TXS1903208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM50831828Medicaid
TX399708201Medicaid
NMNMA100573OtherMEDICARE