Individual
LANDON BERNHARDT LORENZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 WALLS DR STE 503, CLEBURNE, TX 76033-4006
(817) 984-9057
Mailing address
201 WALLS DR STE 503, CLEBURNE, TX 76033-4006
(817) 984-9057
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
23983
OK
207V00000X
Obstetrics & Gynecology Physician
Primary
R3555
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427182682
GROUP NPI
NM
05
—
343208
—
AZ
01
—
MD2008-0332
NEW MEXICO STATE LICENSE
NM
01
—
NM001M59
BCBS PROVIDER ID
NM
Enumeration date
02/09/2007
Last updated
02/25/2022
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