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Organization

LARRY C. WATSON, MD, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LARRY C WATSON M.D. (OWNER)
(281) 333-1703
Entity
Organization

Contact information

Practice address
2060 SPACE PARK DRIVE, #100, HOUSTON, TX 77058-3674
(281) 333-1703
(281) 333-5970
Mailing address
PO BOX 58382, HOUSTON, TX 77258-8382
(281) 333-1703
(281) 333-5970

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0078PZ
BCBS
TX
05
1034248701
TX
Enumeration date
02/27/2007
Last updated
05/11/2009
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