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General NPI Number Information
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NPI Number | 1902416746
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Entity Type | Individual
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Provider Name | LAWRENCE CORCORAN RPH
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Gender | Male
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Dates
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Enumeration Date | 08/06/2020
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Last Update Date | 08/06/2020
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Provider Practice Location Address
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Address Line | 122 W COLLIN ST
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City | LEONARD
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State | TX
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Zip | 75452
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Country | US
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Telephone | 903-587-3363
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Fax |
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Provider Business Mailing Address
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Address Line | 144 RED RD
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City | HOWE
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State | TX
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Zip | 75459-3604
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Country | US
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Telephone |
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 52344
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License Number State | TX
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