Individual
DR. WILLIE E LAWRENCE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
950 SCOTLAND DR, DESOTO, TX 75115-2057
(469) 437-3650
Mailing address
6420 PROSPECT AVE, T-509, KANSAS CITY, MO 64132-4147
(816) 276-4800
(816) 523-1425
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
0423881
KS
207RI0011X
Interventional Cardiology Physician
R8P45
MO
207RI0011X
Interventional Cardiology Physician
Primary
V4139
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004219910
AETNA PPO
—
01
—
060042470
MEDICARE RAILROAD
—
01
—
17894012
BLUE SHIELD OF KC HMO
—
01
—
431092652 A024
CHAMPUS TRICARE
—
Enumeration date
05/19/2006
Last updated
10/13/2025
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