Provider Demographics
NPI:1285894493
Name:TANYA P LAWHON D.D.S.P.A.
Entity type:Organization
Organization Name:TANYA P LAWHON D.D.S.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAYNA
Authorized Official - Middle Name:P
Authorized Official - Last Name:LAWHON
Authorized Official - Suffix:
Authorized Official - Credentials:DDSPA
Authorized Official - Phone:361-584-2217
Mailing Address - Street 1:312 S AVENUE B
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:TX
Mailing Address - Zip Code:78343-2810
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:312 S AVENUE B
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:TX
Practice Address - Zip Code:78343-2810
Practice Address - Country:US
Practice Address - Phone:361-584-2217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21870122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty