Provider Demographics
NPI:1932275922
Name:CHOW, LARA L (DDS)
Entity Type:Individual
Prefix:DR
First Name:LARA
Middle Name:L
Last Name:CHOW
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:LARA
Other - Middle Name:L
Other - Last Name:WELBORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:610 UVALDE DR
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-8392
Mailing Address - Country:US
Mailing Address - Phone:817-743-0610
Mailing Address - Fax:
Practice Address - Street 1:610 UVALDE DR
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-8392
Practice Address - Country:US
Practice Address - Phone:817-760-0376
Practice Address - Fax:817-743-0610
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX231141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice