Provider Demographics
NPI:1548982424
Name:LAWSON, RICHARD ALLEN JR (APRN)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ALLEN
Last Name:LAWSON
Suffix:JR
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 PARKMONT CT
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4889
Mailing Address - Country:US
Mailing Address - Phone:606-694-9192
Mailing Address - Fax:
Practice Address - Street 1:10423 STATE HIGHWAY 151 STE 103
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4768
Practice Address - Country:US
Practice Address - Phone:606-694-9192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1068225363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ML7721170OtherDEA REGISTRATION NUMBER