Healthcare Provider Details

I. General information

NPI: 1578661716
Provider Name (Legal Business Name): ERIC J. LAWITZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 06/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 CAMDEN ST STE 108
SAN ANTONIO TX
78215
US

IV. Provider business mailing address

PO BOX 17650
SAN ANTONIO TX
78217-0650
US

V. Phone/Fax

Practice location:
  • Phone: 210-253-3426
  • Fax: 210-227-6951
Mailing address:
  • Phone: 210-253-3422
  • Fax: 210-227-9833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberL6486
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: