MEDICARE: LORI PRAGER RPH

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	183500000X	Pharmacist	29544	TX

General Provider Information

NPI Number	:	1518546456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI PRAGER RPH

Provider Business Mailing Address
First Line	:	4407 RAMSEY AVE
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78756-3208
Country	:	US
Telephone Number	:	512-797-8556
Fax Number	:

Provider Business Practice Location Address
First Line	:	4018 N LAMAR BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78756-3714
Country	:	US
Telephone Number	:	512-459-9090
Fax Number	:

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

Provider Enumeration Date	:	04/07/2021
Last Update Date	:	04/07/2021

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Directions to “ LORI PRAGER RPH” Practice Location

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