Provider Demographics
NPI:1205153061
Name:SHEPARD, LAUREN KRISTI (DO)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:KRISTI
Last Name:SHEPARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 FROSTWOOD DR
Mailing Address - Street 2:SUITE 1.100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2301
Mailing Address - Country:US
Mailing Address - Phone:713-338-4523
Mailing Address - Fax:
Practice Address - Street 1:23960 KATY FWY
Practice Address - Street 2:SUITE 250
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1339
Practice Address - Country:US
Practice Address - Phone:281-644-8955
Practice Address - Fax:281-644-8959
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0037539208000000X
TXP6917208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0037539OtherTEXAS MEDICAL BOARD