Provider Demographics
NPI:1174992697
Name:LAURA K PREWITT-BUCHANAN MD PA
Entity type:Organization
Organization Name:LAURA K PREWITT-BUCHANAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:KATHRYN
Authorized Official - Last Name:PREWITT-BUCHANAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:512-496-8605
Mailing Address - Street 1:100 COMMONS RD
Mailing Address - Street 2:STE. 7-359
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-4400
Mailing Address - Country:US
Mailing Address - Phone:512-496-8605
Mailing Address - Fax:
Practice Address - Street 1:100 COMMONS RD
Practice Address - Street 2:STE. 7-359
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-4400
Practice Address - Country:US
Practice Address - Phone:512-496-8605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9254208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty