Provider Demographics
NPI:1003830829
Name:FRIEDMAN, LAWRIE HILTON (MD)
Entity Type:Individual
Prefix:
First Name:LAWRIE
Middle Name:HILTON
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 N COIT RD STE 2355
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5477
Mailing Address - Country:US
Mailing Address - Phone:972-644-3422
Mailing Address - Fax:972-644-5543
Practice Address - Street 1:670 N COIT RD STE 2355
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5477
Practice Address - Country:US
Practice Address - Phone:972-644-3422
Practice Address - Fax:972-644-5543
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8113207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00SE27OtherBLUE CROSS
TX00SE27OtherBLUE CROSS
TXC15789Medicare UPIN