Provider Demographics
NPI:1639443435
Name:LAWRENCEG. ROOT, M.D., P.A.
Entity Type:Organization
Organization Name:LAWRENCEG. ROOT, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:C
Authorized Official - Middle Name:
Authorized Official - Last Name:PINCHECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-757-0894
Mailing Address - Street 1:1315 ST. JOSEPH PARKWAY
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002
Mailing Address - Country:US
Mailing Address - Phone:713-757-0894
Mailing Address - Fax:
Practice Address - Street 1:1315 ST JOSEPH PKWY
Practice Address - Street 2:SUITE 1500
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8233
Practice Address - Country:US
Practice Address - Phone:713-757-0894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE46442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty