MEDICARE: MR. LAWRENCE A YANCEY JR. PHARMD

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	183500000X	Pharmacist	56341	TX

General Provider Information

NPI Number	:	1720561434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LAWRENCE A YANCEY JR. PHARMD

Provider Business Mailing Address
First Line	:	500 N CAPITAL OF TEXAS HWY
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-3302
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 N CAPITAL OF TEXAS HWY
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-3302
Country	:	US
Telephone Number	:	512-443-9355
Fax Number	:

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

Provider Enumeration Date	:	09/09/2018
Last Update Date	:	09/09/2018

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