Provider Demographics
NPI:1831295153
Name:SHAFRON, LAWRENCE A (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:A
Last Name:SHAFRON
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 1:2210 SAN JACINTO BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-7527
Mailing Address - Country:US
Mailing Address - Phone:940-382-8000
Mailing Address - Fax:940-383-2608
Practice Address - Street 1:2210 SAN JACINTO BLVD STE 1
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-7531
Practice Address - Country:US
Practice Address - Phone:940-382-8000
Practice Address - Fax:940-383-2608
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ1389207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00H06ZOtherGROUP MEDICARE PIN
TX1760587661OtherGROUP NPI
TX1831295153OtherNPI PERSONAL
TX00H06ZOtherBCBS
TXCS5247OtherRAILROAD MEDICARE
TX752434292OtherTAX ID
TX1760587661OtherGROUP NPI
TX752434292OtherTAX ID
TX5166830001Medicare NSC