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General NPI Number Information
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NPI Number | 1558422089
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Entity Type | Individual
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Provider Name | JOHN LORE MD
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Gender | Male
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 10/04/2013
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Provider Practice Location Address
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Address Line | 919 E 32ND STREET
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City | AUSTIN
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State | TX
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Zip | 78765
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Country | US
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Telephone | 512-404-8145
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Fax | 512-404-8146
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Provider Business Mailing Address
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Address Line | PO BOX 4268
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City | AUSTIN
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State | TX
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Zip | 78765-4268
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Country | US
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Telephone | 512-306-1903
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Fax | 512-382-0303
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | D3919
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207PE0005X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
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License Number | D3919
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License Number State | TX
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