Provider Demographics
NPI:1255380937
Name:ZARIAN, LAWRENCE PETER (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:PETER
Last Name:ZARIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 MEDI PARK DR
Mailing Address - Street 2:SUITE 2050
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2110
Mailing Address - Country:US
Mailing Address - Phone:806-355-3352
Mailing Address - Fax:806-355-5367
Practice Address - Street 1:1901 MEDI PARK DR
Practice Address - Street 2:SUITE 2050
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2110
Practice Address - Country:US
Practice Address - Phone:806-355-3352
Practice Address - Fax:806-355-5367
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036066339174400000X
CO41753174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188435501Medicaid
IL036066339Medicaid
ILE24351Medicare UPIN
ILK22469Medicare ID - Type UnspecifiedGMI COOK COUNTY
ILK21308Medicare ID - Type UnspecifiedAHRC
ILK20372Medicare ID - Type UnspecifiedGRC COOK COUNTY
IL036066339Medicaid
TX8F7885Medicare PIN
ILK20371Medicare ID - Type UnspecifiedGRC LAKE COUNTY
TX188435501Medicaid