| Laura E Pena, MD | |
| 
					2550 Bobcat Blvd Ste 100, Trophy Club, TX 76262-5135  | |
| (817) 347-8100 | |
| (817) 347-8099 | 
| Full Name | Laura E Pena | 
|---|---|
| Gender | Female | 
| Speciality | Pediatrics | 
| Location | 2550 Bobcat Blvd Ste 100, Trophy Club, Texas | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1487098364 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | Q7456 (Texas) | Primary | 
| Entity Name | Kelsey-seybold Medical Group, Pllc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1013915255 PECOS PAC ID: 9739093527 Enrollment ID: O20031117000204  | 
| Entity Name | Cook Childrens Physician Network | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1750369203 PECOS PAC ID: 7719884584 Enrollment ID: O20040128000800  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Laura E Pena, MD Po Box 733784, Dallas, TX 75373-3784 Ph: (682) 885-6483  | Laura E Pena, MD 2550 Bobcat Blvd Ste 100, Trophy Club, TX 76262-5135 Ph: (817) 347-8100  | 
Dr. Charles Okechukwu Onyeama, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 625 Parkview Drive, Suite 102, Trophy Club, TX 76262 Phone: 817-400-1572  | |
Justin Ray Smith, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2300 Sh-114 Ste. 300, Trophy Club, TX 76262 Phone: 817-347-8100 Fax: 817-347-8099  |