Provider Demographics
NPI:1952379901
Name:HUSTON, LAURA FRANCES (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:FRANCES
Last Name:HUSTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 12TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3814
Mailing Address - Country:US
Mailing Address - Phone:512-989-3334
Mailing Address - Fax:
Practice Address - Street 1:103 12TH ST STE 101
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3814
Practice Address - Country:US
Practice Address - Phone:512-989-3334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2022-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1539208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX282279301Medicaid
TXTXB131372Medicare PIN