Provider Demographics
NPI:1518145200
Name:TEIXEIRA, LAWRENCE I (DC)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:I
Last Name:TEIXEIRA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 DOUGLAS AVE
Mailing Address - Street 2:STE. 179
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-5200
Mailing Address - Country:US
Mailing Address - Phone:407-331-5050
Mailing Address - Fax:
Practice Address - Street 1:817 DOUGLAS AVE
Practice Address - Street 2:STE. 179
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-5200
Practice Address - Country:US
Practice Address - Phone:407-331-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8822111N00000X
NC2945111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U84687Medicare UPIN
70060ZMedicare PIN