Individual provider Active NPI

Courtney N Lawrence, M.D.

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1861494957
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
J0059 Issued in TX
Practice address
4212 E Southcross Blvd
Ste 150
San Antonio, TX 78222-3783
Phone
(210) 337-2100
Fax
(210) 337-2242
NPI assigned
Jun 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X J0059 TX Primary

Addresses

Primary practice location

4212 E Southcross Blvd
Ste 150
San Antonio, TX 78222-3783

Mailing address

1954 E Houston St
Suite 104
San Antonio, TX 78202-2951
Phone (210) 576-0533

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J0059TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast South Texas Center for Pediatric Care Pediatrics Past Accepting new patients
Southeast South Texas Center for Pediatric Care Pediatrics 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.

NPI Registry JSON

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

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861494957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1954 E HOUSTON ST",
            "address_2": "SUITE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782022951",
            "telephone_number": "210-576-0533",
            "fax_number": "210-266-4676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 E SOUTHCROSS BLVD",
            "address_2": "STE 150",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782223783",
            "telephone_number": "210-337-2100",
            "fax_number": "210-337-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "COURTNEY",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J0059",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.