Individual provider Active NPI

Laura Marcela Fredes, MD

  • Psychiatry Physician
  • Southlake, TX
National Provider Identifier
1376033779
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
V0394 Issued in TX
Practice address
536 Silicon Dr Ste 102
Southlake, TX 76092-9020
Phone
(817) 203-4179
Fax
(934) 944-2465
NPI assigned
May 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X V0394 TX Primary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 325225 NY
Psychiatry Physician 2084P0800X 0101278966 VA

Addresses

Primary practice location

536 Silicon Dr Ste 102
Southlake, TX 76092-9020

Mailing address

1017 La Salle LN
Southlake, TX 76092-1368
Phone (646) 808-9186

Other names 1

  • Mrs. Laura Marcela Adrianzen Florez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251224000115 TX Practitioner - PsychiatryPractitioner - Neurology 2567700677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Neurology
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1017 La Salle LN
Southlake, TX 76092-1368

590 N Kimball Ave
Suite 100
Southlake, TX 76092-6878

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
325225NYMDLicensed Practical Nurse
V0394TXMDPsychiatry Physician
0101278966VAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mind & Med PLLC Single Specialty CurrentSince Oct 12, 2025 Accepting new patients

Locations

536 Silicon Dr
Ste 102
Southlake, TX 76092
Phone (817) 203-4179

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1376033779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 LA SALLE LN",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921368",
            "telephone_number": "646-808-9186",
            "fax_number": "934-944-2465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 SILICON DR STE 102",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929020",
            "telephone_number": "817-203-4179",
            "fax_number": "934-944-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDES",
        "first_name": "LAURA",
        "middle_name": "MARCELA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-11",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "V0394",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "325225",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101278966",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "ADRIANZEN FLOREZ",
            "middle_name": "MARCELA",
            "prefix": "MRS.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Southlake, TX

Sources for this page

Verify at the official NPI Registry.