Provider Demographics
NPI:1306919410
Name:LAWSON, GLORY
Entity type:Individual
Prefix:
First Name:GLORY
Middle Name:
Last Name:LAWSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2173
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77402-2173
Mailing Address - Country:US
Mailing Address - Phone:832-882-0597
Mailing Address - Fax:
Practice Address - Street 1:19901 SOUTHWEST FWY
Practice Address - Street 2:SUITE 131
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-6538
Practice Address - Country:US
Practice Address - Phone:281-493-5520
Practice Address - Fax:281-341-1474
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1100425363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX531589OtherBCBS
TX4621170001Medicare ID - Type Unspecified