Glenn Lee Lawrence, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

J7807 Issued in TX

Practice address

1700 University Dr E
College Station, TX 77840-2661

Phone

(409) 691-3300

NPI assigned

Mar 29, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Scott & White Clinic

  dba Baylor Scott & White Clinic - Temple

  • Internal Medicine Physician
  • Temple, TX
  • NPI 1093779704

  Pediatrics

  Medicare reassignment NPD
• Scott & White Clinic

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1649820796

  Pediatrics

  NPD
• Scott & White Clinic

  • Internal Medicine Physician
  • Pflugerville, TX
  • NPI 1679691729

  Pediatrics

  NPD
• Scott & White Hospital - Taylor

  dba Baylor Scott & White Medical Center - Taylor

  • Emergency Medicine Physician
  • Taylor, TX
  • NPI 1659366557
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1073574216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY DR E",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778402661",
            "telephone_number": "409-691-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "GLENN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J7807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "81X065",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "glawrence5772@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1700 University Dr E",
            "city": "College Station",
            "state": "TX",
            "country_code": "US",
            "postal_code": "778402661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Iman Lat, PT
• Wilfred Lau, PHARMD
• Brendon Lloyd Lauer, O.D.
• Jodi Laufer
• Mira Lavallee
• Barbara Layman Williams, FNP-BC
• Truc Thanh Le
• Taylor Leahy, RD, LD
• Elizabeth Ferris Leal, FNP-C
• Genevieve Lois Leal, PA-C

• Pediatrics Physician in College Station, TX
• Providers in College Station, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.