Provider Demographics
NPI:1265974638
Name:RABE, LAURA NELSON (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:NELSON
Last Name:RABE
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:ANNE
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2440 N JOSEY LN STE 202
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-1699
Mailing Address - Country:US
Mailing Address - Phone:713-659-9569
Mailing Address - Fax:
Practice Address - Street 1:2440 N JOSEY LN STE 202
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-1699
Practice Address - Country:US
Practice Address - Phone:760-397-2242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-16
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32486122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist