Provider Demographics
NPI:1952320483
Name:LAWLER, TRICIA M (FNP)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:M
Last Name:LAWLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 N. KIMBALL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092
Mailing Address - Country:US
Mailing Address - Phone:817-328-8376
Mailing Address - Fax:817-328-8379
Practice Address - Street 1:620 N. KIMBALL AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092
Practice Address - Country:US
Practice Address - Phone:817-328-8376
Practice Address - Fax:817-328-8379
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP113332363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ78670Medicare UPIN