# TLC FAMILY PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720062367
- **Authorized official:** LAWRENCE R LEBEAU DO (MEMBER PHYSICIAN)
- **Authorized official phone:** (480) 632-7400

## Contact information

- **Practice address:** 428 S GILBERT RD, SUITE 101, GILBERT, AZ 85296-2263
- **Practice address phone:** (480) 632-7400
- **Practice address fax:** (480) 632-8400
- **Mailing address:** 428 S GILBERT RD, SUITE 101, GILBERT, AZ 85296-2263
- **Mailing address phone:** (480) 632-7400
- **Mailing address fax:** (480) 632-8400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 1862 | AZ | — |
| 207Q00000X | Family Medicine Physician | 2822 | AZ | Yes |

## Other

- **Enumeration date:** 12/06/2005
- **Last updated:** 08/22/2020