Provider Demographics
NPI:1669607396
Name:LAUBSCHER, WHITNEY B (PA)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:B
Last Name:LAUBSCHER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5751 EDWARDS RANCH RD STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-4152
Mailing Address - Country:US
Mailing Address - Phone:817-332-8848
Mailing Address - Fax:817-335-2670
Practice Address - Street 1:5751 EDWARDS RANCH RD STE 200
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-4152
Practice Address - Country:US
Practice Address - Phone:817-332-8848
Practice Address - Fax:817-335-2670
Is Sole Proprietor?:No
Enumeration Date:2009-05-26
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X, 363AS0400X
TXPA15844363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1886327Medicaid