MEDICARE: DR. THEODORE LAWLER JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	P4476	TX

General Provider Information

NPI Number	:	1144208414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THEODORE LAWLER JR. M.D.

Provider Business Mailing Address
First Line	:	9055 KATY FRWY
Second Line	:	SUITE 200
City	:	HOUSTON
State	:	TX
Zip	:	77024-1629
Country	:	US
Telephone Number	:	713-461-2915
Fax Number	:	713-461-5307

Provider Business Practice Location Address
First Line	:	8951 RUTHBY ST STE 5
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77061-3142
Country	:	US
Telephone Number	:	713-461-2915
Fax Number	:	713-461-5307

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	07/21/2022

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