Provider Demographics
NPI:1386611044
Name:MARTIN, LAURA MCALPIN (MD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MCALPIN
Last Name:MARTIN
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 1:801 MEDICAL CIRCLE DR.
Mailing Address - Street 2:SUITE E
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-5101
Mailing Address - Country:US
Mailing Address - Phone:903-247-2050
Mailing Address - Fax:903-247-2054
Practice Address - Street 1:801 MEDICAL CIRCLE DR.
Practice Address - Street 2:SUITE E
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-5101
Practice Address - Country:US
Practice Address - Phone:903-247-2050
Practice Address - Fax:903-247-2054
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5722207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136020802Medicaid
TX87811NMedicare ID - Type Unspecified
TX136020802Medicaid