MEDICARE: LORRIE E BAGGS MA

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	237700000X	Hearing Instrument Specialist	51204	TX

General Provider Information

NPI Number	:	1316298052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORRIE E BAGGS MA

Provider Business Mailing Address
First Line	:	1528 COMMON ST
Second Line	:	SUITE 5
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-3337
Country	:	US
Telephone Number	:	830-643-0033
Fax Number	:	830-643-0350

Provider Business Practice Location Address
First Line	:	136 OLD SAN ANTONIO RD
Second Line	:	SUITE 205
City	:	BOERNE
State	:	TX
Zip	:	78006-3413
Country	:	US
Telephone Number	:	830-609-9056
Fax Number	:	830-331-8145

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

Provider Enumeration Date	:	09/20/2012
Last Update Date	:	01/28/2014

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