Provider Demographics
NPI:1902800402
Name:ABREU-LAWRENCE, CHARITY VIRGINIA (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARITY
Middle Name:VIRGINIA
Last Name:ABREU-LAWRENCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:910 S BRYAN RD
Mailing Address - Street 2:STE 105
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-6615
Mailing Address - Country:US
Mailing Address - Phone:956-581-0539
Mailing Address - Fax:956-323-1499
Practice Address - Street 1:910 S BRYAN RD
Practice Address - Street 2:STE 105
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-6615
Practice Address - Country:US
Practice Address - Phone:956-581-0539
Practice Address - Fax:956-323-1499
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8856207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX096777002Medicaid
TX096777002Medicaid
TX0061APMedicare PIN