Provider Demographics
NPI:1720192040
Name:YOLANDA LAWSON, M.D, P.A
Entity Type:Organization
Organization Name:YOLANDA LAWSON, M.D, P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-821-5400
Mailing Address - Street 1:2509 THOMAS AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-2039
Mailing Address - Country:US
Mailing Address - Phone:214-821-5400
Mailing Address - Fax:214-821-5415
Practice Address - Street 1:2509 THOMAS AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201
Practice Address - Country:US
Practice Address - Phone:214-821-5400
Practice Address - Fax:214-821-5415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4519207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160567702Medicaid
TX0061PZOtherBC/BS
TX0061PZOtherBC/BS
TXH71437Medicare UPIN