Healthcare Provider Details

I. General information

NPI: 1457392284
Provider Name (Legal Business Name): RICHARD FRANCIS LORENZ D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 03/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14107 WOODVILLE GARDENS DR
HOUSTON TX
77077-1432
US

IV. Provider business mailing address

14107 WOODVILLE GARDENS DR
HOUSTON TX
77077-1432
US

V. Phone/Fax

Practice location:
  • Phone: 281-597-1302
  • Fax: 281-597-8972
Mailing address:
  • Phone: 281-597-1302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberH8221
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: