Provider Demographics
NPI:1235159146
Name:LENDERMAN, LAWRENCE L (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:L
Last Name:LENDERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:LAWRENCE
Other - Middle Name:L
Other - Last Name:LENDERMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2424 BABCOCK RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-6031
Mailing Address - Country:US
Mailing Address - Phone:210-616-0802
Mailing Address - Fax:210-616-0155
Practice Address - Street 1:2424 BABCOCK RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-6031
Practice Address - Country:US
Practice Address - Phone:210-616-0802
Practice Address - Fax:210-616-0155
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8554207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB24341Medicare UPIN
TX00HS13Medicare PIN