Provider Demographics
NPI:1336923614
Name:SEGURA BOZA, LAURA (FNP-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:SEGURA BOZA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 14TH ST STE 145
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-6445
Mailing Address - Country:US
Mailing Address - Phone:832-245-7086
Mailing Address - Fax:
Practice Address - Street 1:2300 14TH ST STE 145
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-6445
Practice Address - Country:US
Practice Address - Phone:469-277-8858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-18
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1131553363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily