Individual
RICHARD W. LAURENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSA
Contact information
Practice address
7925 COLDSHIRE CT, NORTH RICHLAND HILLS, TX 76180-1045
(817) 281-1196
(817) 281-7404
Mailing address
7925 COLDSHIRE CT, NORTH RICHLAND HILLS, TX 76180-1045
(817) 281-1196
(817) 281-7404
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
SA00079
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0081JR
BLUE CROSS
TX
Enumeration date
10/10/2006
Last updated
07/08/2007
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