Healthcare Provider Details

I. General information

NPI: 1023912714
Provider Name (Legal Business Name): ERIKA LYNN LAGOUTARIS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIKA GOSS APRN

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/11/2026
Certification Date: 10/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3811 W GORE BLVD STE 6
LAWTON OK
73505-6328
US

IV. Provider business mailing address

1803 SW SHERIDAN RD
LAWTON OK
73505-8629
US

V. Phone/Fax

Practice location:
  • Phone: 580-250-6525
  • Fax:
Mailing address:
  • Phone: 580-351-1031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number207411
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: