Provider Demographics
NPI:1578661716
Name:LAWITZ, ERIC J (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:J
Last Name:LAWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 17650
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-0650
Mailing Address - Country:US
Mailing Address - Phone:210-253-3422
Mailing Address - Fax:210-227-9833
Practice Address - Street 1:607 CAMDEN ST STE 108
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215
Practice Address - Country:US
Practice Address - Phone:210-253-3426
Practice Address - Fax:210-227-6951
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6486207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165013701Medicaid
TXP00191567OtherMEDICARE - RAILROAD
TX8K9485OtherBC/BS
TX8K9485OtherBC/BS
TXP00191567OtherMEDICARE - RAILROAD