Provider Demographics
NPI:1750651584
Name:MILLS, LAWRENCE JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:JAY
Last Name:MILLS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9154 STONE CREEK PL
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6217
Mailing Address - Country:US
Mailing Address - Phone:214-437-8360
Mailing Address - Fax:970-923-6206
Practice Address - Street 1:9154 STONE CREEK PL
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6217
Practice Address - Country:US
Practice Address - Phone:214-437-8360
Practice Address - Fax:970-923-6206
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAAFE23515208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)