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General NPI Number Information
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NPI Number | 1639443435
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Entity Type | Organization
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Legal Business Name | LAWRENCEG. ROOT, M.D., P.A.
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Dates
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Enumeration Date | 02/27/2012
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Last Update Date | 02/27/2012
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Provider Practice Location Address
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Address Line | 1315 ST JOSEPH PKWY SUITE 1500
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City | HOUSTON
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State | TX
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Zip | 77002-8233
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Country | US
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Telephone | 713-757-0894
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Fax |
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Provider Business Mailing Address
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Address Line | 1315 ST. JOSEPH PARKWAY SUITE 1500
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City | HOUSTON
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State | TX
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Zip | 77002
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Country | US
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Telephone | 713-757-0894
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MS. C PINCHECK
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Credential |
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Telephone | 713-757-0894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | E4644
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License Number State | TX
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