Provider Demographics
NPI:1962821850
Name:SHEEDY, LAURA (MSPAS, PA-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:SHEEDY
Suffix:
Gender:F
Credentials:MSPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7616 BRANFORD PL STE 240
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3794
Mailing Address - Country:US
Mailing Address - Phone:281-240-4313
Mailing Address - Fax:281-240-3646
Practice Address - Street 1:7616 BRANFORD PL STE 240
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3794
Practice Address - Country:US
Practice Address - Phone:281-240-4313
Practice Address - Fax:281-240-3646
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08977363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant