Provider Demographics
NPI:1740494012
Name:LAWHON, TANYA P (DDS)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:P
Last Name:LAWHON
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:PO BOX 865
Mailing Address - Street 2:312 S AVE B
Mailing Address - City:BISHOP
Mailing Address - State:TX
Mailing Address - Zip Code:78343
Mailing Address - Country:US
Mailing Address - Phone:361-584-2217
Mailing Address - Fax:361-584-2872
Practice Address - Street 1:312 S AVE B
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:TX
Practice Address - Zip Code:78343
Practice Address - Country:US
Practice Address - Phone:361-584-2217
Practice Address - Fax:361-584-2872
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21870122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist