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General NPI Number Information
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NPI Number | 1164421103
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Entity Type | Individual
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Provider Name | LAWRENCE W SANDERS M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 01/05/2025
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Provider Practice Location Address
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Address Line | 1801 S GULFWAY DR
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City | PORT ARTHUR
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State | TX
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Zip | 77640-4416
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Country | US
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Telephone | 409-985-1819
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Fax | 409-985-1079
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Provider Business Mailing Address
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Address Line | 2200 HIGHWAY 365
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City | NEDERLAND
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State | TX
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Zip | 77627-5506
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Country | US
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Telephone | 409-722-4321
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Fax | 409-729-2332
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G5568
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License Number State | TX
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