Individual
LARRY C WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2060 SPACE PARK DR, SUITE 100, HOUSTON, TX 77058-3600
(281) 333-1703
(281) 333-5970
Mailing address
2060 SPACE PARK DR, SUITE 100, HOUSTON, TX 77058-3600
(281) 333-1703
(281) 333-5970
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
D9711
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
034248701
—
TX
05
—
034248702
—
TX
05
—
034248703
—
TX
01
—
8AJ295
BCBS
TX
01
—
8ER636
BCBS
TX
01
—
8GD916
BCBS
TX
Enumeration date
06/28/2006
Last updated
01/17/2017
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