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General NPI Number Information
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NPI Number | 1235218348
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Entity Type | Organization
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Legal Business Name | LORI GORE-GREEN, D.O., PA.
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 209 N BONNIE BRAE ST STE 204
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City | DENTON
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State | TX
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Zip | 76201-3748
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Country | US
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Telephone | 940-387-3744
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Fax |
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Provider Business Mailing Address
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Address Line | 209 N BONNIE BRAE ST STE 204
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City | DENTON
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State | TX
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Zip | 76201-3748
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYICAN
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Name | LORI GORE-GREEN
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Credential | D.O.
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Telephone | 940-387-3744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | K7545
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License Number State | TX
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