Provider Demographics
NPI:1255603411
Name:EDMUNDSON, LAURA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:EDMUNDSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 S CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75901-4905
Mailing Address - Country:US
Mailing Address - Phone:936-637-7066
Mailing Address - Fax:936-637-7058
Practice Address - Street 1:301 S CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75901-4905
Practice Address - Country:US
Practice Address - Phone:936-637-7066
Practice Address - Fax:936-637-7058
Is Sole Proprietor?:No
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48570183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist