Provider Demographics
NPI:1295500379
Name:SIMPSON, LAUREN DIOR
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:DIOR
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 ELM FALLS PL
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181
Mailing Address - Country:US
Mailing Address - Phone:972-971-6937
Mailing Address - Fax:
Practice Address - Street 1:604 ELM FALLS PL
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75181
Practice Address - Country:US
Practice Address - Phone:972-971-6937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64783183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist