Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | F1944 | TX |
N | 207Q00000X | Family Doctor | F1944 | TX |
NPI | 1013037696 |
---|---|
Provider Name | Lawrence Quinn Robinson |
First Address | Nacogdoches, TX 75965-1543 |
Second Address | Nacogdoches, TX 75961-4027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C21170 | (02) | TX |