Provider Demographics
NPI:1285634055
Name:MEYERSON, LAWRENCE B (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:B
Last Name:MEYERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 N MACARTHUR BLVD #300
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-2113
Mailing Address - Country:US
Mailing Address - Phone:972-254-3118
Mailing Address - Fax:972-253-7814
Practice Address - Street 1:2021 N MACARTHUR BLVD #300
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2113
Practice Address - Country:US
Practice Address - Phone:972-254-3118
Practice Address - Fax:972-253-7814
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD8034207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX888456Medicare PIN
TXB24888Medicare UPIN
TX070003517Medicare PIN