Individual
DR. LAWRENCE PAUL ELIKAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 561-4500
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
BP3-0029858
TX
207L00000X
Anesthesiology Physician
Primary
N6279
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
215463502
—
TX
01
—
75-2616977-042
TRICARE
TX
01
—
8ET141
BCBS
TX
01
—
P01417786
RAIL ROAD MEDICARE
TX
Enumeration date
10/10/2007
Last updated
03/20/2015
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