Provider Demographics
NPI:1629336243
Name:LAWRENCE, YURI ALEXANDER (DVM, PHD)
Entity Type:Individual
Prefix:DR
First Name:YURI
Middle Name:ALEXANDER
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:DVM, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9308 VILLA NORTE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78726-2362
Mailing Address - Country:US
Mailing Address - Phone:617-838-7228
Mailing Address - Fax:
Practice Address - Street 1:7300 RANCH ROAD 2222
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78730
Practice Address - Country:US
Practice Address - Phone:512-343-2837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13664207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty