Provider Demographics
NPI:1508195678
Name:MEALS, LAUREN LEPORI (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:LEPORI
Last Name:MEALS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:NICOLE
Other - Last Name:LEPORI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:MC7977
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-450-4000
Mailing Address - Fax:210-450-4903
Practice Address - Street 1:4502 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4402
Practice Address - Country:US
Practice Address - Phone:210-358-2078
Practice Address - Fax:210-358-1972
Is Sole Proprietor?:No
Enumeration Date:2009-12-18
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06429363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX212714402Medicaid
TXTXB115010Medicare PIN