Provider Demographics
NPI:1285637215
Name:LAWLER, GERRY N (MD)
Entity type:Individual
Prefix:DR
First Name:GERRY
Middle Name:N
Last Name:LAWLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 PINE ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2432
Mailing Address - Country:US
Mailing Address - Phone:325-670-2000
Mailing Address - Fax:
Practice Address - Street 1:1900 PINE ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2432
Practice Address - Country:US
Practice Address - Phone:325-670-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2019-11-07
Deactivation Date:2019-10-25
Deactivation Code:
Reactivation Date:2019-11-07
Provider Licenses
StateLicense IDTaxonomies
TXE4472207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX114706804Medicaid
TX8A4414Medicare ID - Type UnspecifiedINDIVIDUAL #
TXC18193Medicare UPIN