Provider Demographics
NPI:1851596811
Name:LAWSON, TARA MICHELLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:MICHELLE
Last Name:LAWSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4903 82ND STREET
Mailing Address - Street 2:SUITE 20
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424
Mailing Address - Country:US
Mailing Address - Phone:806-798-2996
Mailing Address - Fax:806-798-2998
Practice Address - Street 1:4903 82ND STREET
Practice Address - Street 2:SUITE 20
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424
Practice Address - Country:US
Practice Address - Phone:806-798-2996
Practice Address - Fax:806-798-2998
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX233751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice