Provider Demographics
NPI:1235303728
Name:JOHN P. LACSON, MD
Entity Type:Organization
Organization Name:JOHN P. LACSON, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:LACSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-626-9971
Mailing Address - Street 1:4126 SOUTHWEST FWY STE 600C
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7317
Mailing Address - Country:US
Mailing Address - Phone:713-626-9981
Mailing Address - Fax:
Practice Address - Street 1:4126 SOUTHWEST FWY STE 600C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7317
Practice Address - Country:US
Practice Address - Phone:713-626-9981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7806207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG37787Medicare UPIN