Provider Demographics
NPI:1841511912
Name:PICKARD, LANCE ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:LANCE
Middle Name:ROBERT
Last Name:PICKARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8845 SIX PINES DR FL 2
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2675
Mailing Address - Country:US
Mailing Address - Phone:281-602-0509
Mailing Address - Fax:855-308-0364
Practice Address - Street 1:8845 SIX PINES DR FL 2
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-2675
Practice Address - Country:US
Practice Address - Phone:281-602-0509
Practice Address - Fax:855-308-0364
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP2153207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine