Healthcare Provider Details

I. General information

NPI: 1194428417
Provider Name (Legal Business Name): ZACHARY M LAWRENCE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 03/24/2023
Certification Date: 03/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E DAWSON ST
TYLER TX
75701-2036
US

IV. Provider business mailing address

2905 SALADO CREEK DR
TYLER TX
75703-6046
US

V. Phone/Fax

Practice location:
  • Phone: 903-606-4223
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number62435
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: