Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 10422 | TX |
Y | 213EG0000X | General Practice | 10422 | TX |
N | 1223P0221X | Pediatric Dentist | 10422 | TX |
NPI | 1043215056 |
---|---|
Provider Name | Dr. Lawrence Binkley Lanham |
First Address | Dallas, TX 75230-4046 |
Second Address | Garland, TX 75042-4201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 01/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
111155104 | (05) | TX |