Healthcare Provider Details

I. General information

NPI: 1235185307
Provider Name (Legal Business Name): LORENZO SPRATT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

387 W I H 10
FORT STOCKTON TX
79735-2700
US

IV. Provider business mailing address

738 MORGAN CIR
CEDAR HILL TX
75104-4236
US

V. Phone/Fax

Practice location:
  • Phone: 432-336-8640
  • Fax:
Mailing address:
  • Phone: 469-272-7314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberF9031
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: