| Dr Laurel L Humphrey, MD | |
|
Two St. Mark's Place, Suite 130, La Grange, TX 78945-1259 | |
| (979) 242-5605 | |
| (979) 242-5619 |
| Full Name | Dr Laurel L Humphrey |
|---|---|
| Gender | Female |
| Speciality | General Surgery |
| Experience | 26 Years |
| Location | Two St. Mark's Place, La Grange, Texas |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336185321 | NPI | - | NPPES |
| 184272601 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | M1773 (Texas) | Primary |
| 174400000X | Specialist | (* (Not Available)) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| University Of Texas Medical Branch Galveston | Galveston, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Utmb Faculty Group Practice | 3375456734 | 948 |
| Entity Name | Utmb Faculty Group Practice |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942241146 PECOS PAC ID: 3375456734 Enrollment ID: O20031112000438 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Laurel L Humphrey, MD Two St. Mark's Place, Suite 130, La Grange, TX 78945-1259 Ph: (979) 242-5605 | Dr Laurel L Humphrey, MD Two St. Mark's Place, Suite 130, La Grange, TX 78945-1259 Ph: (979) 242-5605 |
Anant Chelva Praba, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 2 Saint Marks Pl, Suite 130, La Grange, TX 78945 Phone: 979-242-5605 Fax: 979-242-5619 | |
Russell Joseph Juno Iii, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1720 Von Minden Rd, La Grange, TX 78945 Phone: 979-968-2700 Fax: 979-968-2733 | |
Albert Louis Chorens, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 2 Saint Marks Pl, Suite 130, La Grange, TX 78945 Phone: 979-242-5605 Fax: 979-242-5619 |