Lawrence Lane Fan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G8099 Issued in TX

Practice address

11555 University Blvd
Sugar Land, TX 77478-3889

Phone

(713) 442-0000

NPI assigned

Nov 1, 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 3

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

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.

• Kelsey-Seybold Medical Group, PLLC

  dba Kelsey Seybold Clinic

  • Multi-Specialty Clinic/Center
  • Houston, TX
  • NPI 1013915255

  Pediatrics

  Medicare reassignment NPD
• Village Chiropractic and Wellness P.L.L.C.

  dba Cornerstone Chiropractic

  • Chiropractor
  • League City, TX
  • NPI 1972750719
  NPD (past)
• Laboratory Corporation of America

  • Clinical Medical Laboratory
  • Walla Walla, WA
  • NPI 1972485621
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1477631398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11555 UNIVERSITY BLVD",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783889",
            "telephone_number": "713-442-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAN",
        "first_name": "LAWRENCE",
        "middle_name": "LANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "G8099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116683708",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116683709",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116683707",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Practice Associates of Houston
• Family Smiles in SL (Family Smiles Dental Care)
• Family Therapy Solutions, PLLC
• Famous Medical Supply Inc
• Alex Fan
• Desiree Monique Fancher, CNA, BT,
• Fancyherhair LLC
• Andrea Farb, LCSW
• Rabia Farhan, BCBA
• Fahim Michel Farhat, MD

• Pediatrics Physician in Sugar Land, TX
• Providers in Sugar Land, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.