Organization
LAWRENCE L ANDERSON MD PA
Active
Parent organization
LAWRENCE L ANDERSON MD PA
Other names
Derm Path Lab
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAWRENCE L ANDERSON MD PA
Authorized official
ANDREA LYNNE STEIN RN (PRACTICE ADMINISTRATOR)
(903) 534-6200
Entity
Organization
Contact information
Practice address
1367 DOMINION PLZ, TYLER, TX 75703-1013
(903) 534-6200
(903) 939-0755
Mailing address
1367 DOMINION PLZ, TYLER, TX 75703-1013
(903) 534-6200
(903) 939-0755
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085541301
—
TX
01
—
CN9571
RAILROAD MEDICARE PTAN
TX
Enumeration date
05/29/2008
Last updated
05/29/2008
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