MEDICARE: LORI VEST-DENNISON PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA06112	TX

General Provider Information

NPI Number	:	1174578900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI VEST-DENNISON PA

Provider Business Mailing Address
First Line	:	257 PARADISE HILLS
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78132-2243
Country	:	US
Telephone Number	:	830-226-7004
Fax Number	:

Provider Business Practice Location Address
First Line	:	257 PARADISE HILLS
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78132-2243
Country	:	US
Telephone Number	:	830-226-7004
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	03/10/2016

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Directions to “ LORI VEST-DENNISON PA” Practice Location

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