Active NPI
Lawrence G Tatum, M.D.
- Emergency Medicine Physician
- San Antonio, TX
National Provider Identifier
1194719955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- H0873
- Practice address
- 111 Dallas St
San Antonio, TX 78205-1201 - Phone
- (210) 495-9860
- NPI assigned
- Sep 8, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | H0873 | TX | |
| Emergency Medicine Physician | 207P00000X | H0873 | TX | Primary |
Addresses
Primary practice location
111 Dallas St
San Antonio, TX 78205-1201
Mailing address
PO Box 12740
Westminster, CA 92685-2740
Phone (562) 468-0227
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110553801 | Medicaid | TX | |
| 8N2617 | Other | TX | BCBS |
| 110553804 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H0873 | TX | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Leading Edge Emergency Physicians, Inc | Emergency Medicine | Past | Accepting new patients |
| River City Emergency Physicians, PLLC | Emergency Medicine | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Emergency Medicine Physician
- San Antonio, TX
- NPI 1003165259
-
- Emergency Medicine Physician
- San Antonio, TX
- NPI 1164645297
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266364800000",
"number": "1194719955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12740",
"city": "WESTMINSTER",
"state": "CA",
"postal_code": "926852740",
"telephone_number": "562-468-0227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 DALLAS ST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782051201",
"telephone_number": "210-495-9860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TATUM",
"first_name": "LAWRENCE",
"middle_name": "G",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-08",
"last_updated": "2010-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "H0873",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "TX",
"license": "H0873",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110553801",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8N2617",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110553804",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.