Provider Demographics
NPI:1720679285
Name:FOLEY, LAURIE J
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:J
Last Name:FOLEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31007 I-10
Mailing Address - Street 2:110
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78000
Mailing Address - Country:US
Mailing Address - Phone:830-444-4930
Mailing Address - Fax:830-239-9927
Practice Address - Street 1:31007 1-10
Practice Address - Street 2:110
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006
Practice Address - Country:US
Practice Address - Phone:830-444-4930
Practice Address - Fax:830-239-9927
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1025784363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1982836532Medicaid