Provider Demographics
NPI:1205045358
Name:SCURRIA, LAWRENCE J (RPH)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:J
Last Name:SCURRIA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7221 LA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-4227
Mailing Address - Country:US
Mailing Address - Phone:214-590-2881
Mailing Address - Fax:
Practice Address - Street 1:4917 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7718
Practice Address - Country:US
Practice Address - Phone:214-590-2881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35396183500000X
LA14972183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist