Healthcare Provider Details

I. General information

NPI: 1871628859
Provider Name (Legal Business Name): LAWRENCE M. COHEN M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 08/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 BLANCO RD STE 503
SAN ANTONIO TX
78216-4941
US

IV. Provider business mailing address

7300 BLANCO RD STE 503
SAN ANTONIO TX
78216-4941
US

V. Phone/Fax

Practice location:
  • Phone: 210-733-0990
  • Fax: 210-733-9603
Mailing address:
  • Phone: 210-733-0990
  • Fax: 210-733-9603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberF2601
License Number StateTX

VIII. Authorized Official

Name: DR. LAWRENCE MICHAEL COHEN
Title or Position: OWNER,PRESIDENT
Credential: M.D.
Phone: 210-733-0990