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General NPI Number Information
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NPI Number | 1245400779
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Entity Type | Organization
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Legal Business Name | R. LAWRENCE MAGRUDER, MD PLLC
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Dates
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Enumeration Date | 03/12/2008
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 6800 HERITAGE PKWY SUITE 102
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City | ROCKWALL
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State | TX
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Zip | 75087-8746
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Country | US
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Telephone | 972-463-2991
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Fax | 942-463-2997
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Provider Business Mailing Address
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Address Line | 6800 HERITAGE PKWY SUITE 102
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City | ROCKWALL
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State | TX
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Zip | 75087-8746
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Country | US
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Telephone | 972-463-2991
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Fax | 942-463-2997
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT LAWRENCE MAGRUDER
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Credential | MD
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Telephone | 972-463-2991
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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 | G5325
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License Number State | TX
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