Provider Demographics
NPI:1164887410
Name:OBI, LAWRENCE
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:OBI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7115 S MASON RD
Mailing Address - Street 2:# 1911
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-4474
Mailing Address - Country:US
Mailing Address - Phone:248-794-5065
Mailing Address - Fax:832-945-2192
Practice Address - Street 1:7115 S MASON RD
Practice Address - Street 2:# 1911
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-4474
Practice Address - Country:US
Practice Address - Phone:248-794-5065
Practice Address - Fax:832-945-2192
Is Sole Proprietor?:No
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant