Provider Demographics
NPI:1487818738
Name:KOEHLER, LAURA VRAZEL (OD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:VRAZEL
Last Name:KOEHLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 E FM 646 RD STE A
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-7478
Mailing Address - Country:US
Mailing Address - Phone:281-337-3344
Mailing Address - Fax:281-337-3340
Practice Address - Street 1:601 E FM 646 RD STE A
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-7478
Practice Address - Country:US
Practice Address - Phone:281-337-3344
Practice Address - Fax:281-337-3340
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7215TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F8948Medicare UPIN
6370320001Medicare NSC