Individual
MR. BRENT EDWARD LAWLER SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
2508 ADAMS AVE, ODESSA, TX 79761-1349
(727) 510-8719
Mailing address
2508 ADAMS AVE, ODESSA, TX 79761-1349
(727) 510-8719
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
14174
FL
314000000X
Skilled Nursing Facility
Primary
213085
TX
Other
Enumeration date
06/22/2016
Last updated
06/22/2016
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