Tatum, Lawrence G

Tatum, Lawrence G is an sole proprietor health care provider with primary practice located at 111 Dallas St , San Antonio TX 78205-1201. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Tatum, Lawrence G can be contacted via phone (210) 495-9860.

Contact Information

Primary practice address
111 Dallas St San Antonio TX 78205-1201
Phone: (210) 495-9860
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X H0873 Texas
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X H0873 Texas

Profile Details

NPI number 1194719955
LBN Legal business name Tatum, Lawrence G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 8th, 2005
Last updated Feb 17th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194719955 NPPES
Texas MEDICAID 110553801
Texas Other 8N2617
Texas MEDICAID 110553804

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