Provider Demographics
NPI:1538803309
Name:LAWRENCE, SYDNEY (PA-C)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 RIVER LODGE TRL S APT 1231
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-0870
Mailing Address - Country:US
Mailing Address - Phone:214-783-8630
Mailing Address - Fax:
Practice Address - Street 1:5040 ADDISON CIR FL 4
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-3333
Practice Address - Country:US
Practice Address - Phone:855-898-2655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant