Provider Demographics
NPI:1124042791
Name:HOUSTON, LAWRENCE MORLEY (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:MORLEY
Last Name:HOUSTON
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 1:12701 METCALF AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-2617
Mailing Address - Country:US
Mailing Address - Phone:913-383-0711
Mailing Address - Fax:
Practice Address - Street 1:12701 METCALF AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-2617
Practice Address - Country:US
Practice Address - Phone:913-383-0711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18123207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
40193015OtherBLUE CROSS BLUE SHIELD OF KANSAS CITY
40193015OtherBLUE CROSS BLUE SHIELD OF KANSAS CITY
KSC50365Medicare UPIN