Provider Demographics
NPI:1457351074
Name:LAWRIE, GERALD MURRAY (MD)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:MURRAY
Last Name:LAWRIE
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 1:6560 FANNIN ST
Mailing Address - Street 2:SUITE 1842
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2761
Mailing Address - Country:US
Mailing Address - Phone:713-790-2089
Mailing Address - Fax:713-794-0576
Practice Address - Street 1:6560 FANNIN ST
Practice Address - Street 2:SUITE 1842
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2761
Practice Address - Country:US
Practice Address - Phone:713-790-2089
Practice Address - Fax:713-794-0576
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4473208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128830007Medicaid
TX1288300-05Medicaid
TX8DW015OtherBLUE CROSS BLUE SHIELD
TX8GD954OtherBCBS
TX128830006Medicaid
110-146-8OtherBCFMG
TX89815BOtherBCBS
TXP01267151OtherRR MEDICARE
TX89815BMedicare PIN
TX298680ZSWDMedicare PIN
TX128830006Medicaid
C18207Medicare UPIN