Provider Demographics
NPI:1689851370
Name:CONNER, LAUREN DE'AN (PA-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:DE'AN
Last Name:CONNER
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W PARK STE 106
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-8338
Mailing Address - Country:US
Mailing Address - Phone:936-262-7161
Mailing Address - Fax:936-262-7152
Practice Address - Street 1:210 W PARK STE 106
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-8338
Practice Address - Country:US
Practice Address - Phone:936-262-7161
Practice Address - Fax:936-262-7152
Is Sole Proprietor?:No
Enumeration Date:2008-01-25
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05605363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical