Individual provider Active NPI

Laurens Russell Pickard, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Houston, TX
National Provider Identifier
1902980410
Registry record updated Sep 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
D7249 Issued in TX
Practice address
6560 Fannin St
Suite 1846
Houston, TX 77030-2761
Phone
(713) 797-1211
Fax
(713) 795-9805
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X D7249 TX
Pediatric Surgery Physician 2086S0120X D7249 TX
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X D7249 TX Primary

Addresses

Primary practice location

6560 Fannin St
Suite 1846
Houston, TX 77030-2761

Mailing address

PO Box 128
Bellaire, TX 77402-0128
Phone (281) 833-3330

Other identifiers 1

IdentifierTypeStateIssuer
130331505MedicaidTX

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20081008000479 TX Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 6608944327 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children CurrentSince Mar 23, 2021 Accepting new patients
Shriners Hospitals for Children Pediatric Surgery CurrentSince Mar 23, 2021 Accepting new patients
Karl E Tomm M D & Associates Surgery Past Accepting new patients

Locations

815 Market St
Galveston, TX 77550
Phone (409) 770-6600

Organizations & group practices 3

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1902980410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 128",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774020128",
            "telephone_number": "281-833-3330",
            "fax_number": "281-833-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6560 FANNIN ST",
            "address_2": "SUITE 1846",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302761",
            "telephone_number": "713-797-1211",
            "fax_number": "713-795-9805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKARD",
        "first_name": "LAURENS",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "D7249",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "TX",
            "license": "D7249",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "D7249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130331505",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.