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Organization
R. LAWRENCE MAGRUDER, MD PLLC
Active
Organization
R. LAWRENCE MAGRUDER, MD PLLC
Active
Other names
Lakeside Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT LAWRENCE MAGRUDER MD (OWNER)
(972) 463-2991
Entity
Organization
Contact information
Practice address
6800 HERITAGE PKWY, SUITE 102, ROCKWALL, TX 75087-8746
(972) 463-2991
(942) 463-2997
Mailing address
6800 HERITAGE PKWY, SUITE 102, ROCKWALL, TX 75087-8746
(972) 463-2991
(942) 463-2997
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G5325
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00980W
PTAM
TX
05
—
100200
—
TX
Enumeration date
03/12/2008
Last updated
03/12/2008
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