Individual
LAURENCE W TIPPIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-4000
Mailing address
7703 FLOYD CURL DR # MC7977, SAN ANTONIO, TX 78229-3901
(210) 358-4000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP136200
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
380294401
—
TX
01
—
380294402
CSHCN
TX
Enumeration date
01/04/2018
Last updated
03/20/2018
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