Dr LACONIA A BACON is a female medical professional, specializing in Nurse Practitioner. She graduated in 2014.
WOODROME MEDICAL PA
1930 US HWY 190 W
LIVINGSTON
TX
773519600
Tel: 9363279944
| Npi | 1144628157 |
| Pac Id | 9931428620 |
| Professional Enrollment Id | I20150430001678 |
| Last Name | BACON |
| First Name | LACONIA |
| Middle Name | A |
| Suffix | |
| Gender | F |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 2014 |
| Primary Specialty | NURSE PRACTITIONER |
| Secondary Specialty 1 | |
| Secondary Specialty 2 | |
| Secondary Specialty 3 | |
| Secondary Specialty 4 | |
| All Secondary Specialties | |
| Organization Legal Name | WOODROME MEDICAL PA |
| Group Practice Pac Id | 3476553579 |
| Number Of Group Practice Members | 7 |
| Line 1 Street Address | 1930 US HWY 190 W |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | LIVINGSTON |
| State | TX |
| Zip Code | 773519600 |
| Phone Number | 9363279944 |
| Hospital Affiliation Ccn 1 | 450573 |
| Hospital Affiliation Lbn 1 | CHRISTUS JASPER MEMORIAL HOSPITAL |
| Hospital Affiliation Ccn 2 | 450395 |
| Hospital Affiliation Lbn 2 | MEMORIAL MEDICAL CENTER LIVINGSTON |
| Hospital Affiliation Ccn 3 | |
| Hospital Affiliation Lbn 3 | |
| Hospital Affiliation Ccn 4 | |
| Hospital Affiliation Lbn 4 | |
| Hospital Affiliation Ccn 5 | |
| Hospital Affiliation Lbn 5 | |
| Professional Accepts Medicare Assignment | Y |
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