Provider Demographics
NPI:1164765905
Name:LAWNIN, NELSON REYNOLDS (DDS)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:REYNOLDS
Last Name:LAWNIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 MALONE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-5123
Mailing Address - Country:US
Mailing Address - Phone:713-588-4647
Mailing Address - Fax:
Practice Address - Street 1:715 MALONE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-5123
Practice Address - Country:US
Practice Address - Phone:713-588-4647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-30
Last Update Date:2013-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28722122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist