Organization
LAWRENCE WARREN, D.P.M.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE WARREN D.P.M. (OWNER)
(817) 921-5339
Entity
Organization
Contact information
Practice address
3109 6TH AVE, FORT WORTH, TX 76110-3800
(817) 921-5339
Mailing address
3109 6TH AVE, FORT WORTH, TX 76110-3800
(817) 921-5339
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0465
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0070PW
BLUE CROSS BLUE SHIELD
TX
01
—
00Z585
MEDICARE
TX
Enumeration date
07/02/2006
Last updated
02/16/2010
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