MEDICARE: LORI J. PARKER LSA, CSFA

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	246ZC0007X	Surgical Assistant	00F585/SA00006	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SA00006	OTHER	TX	TEXAS MEDICAL BOARD

General Provider Information

NPI Number	:	1548273543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI J. PARKER LSA, CSFA

Provider Business Mailing Address
First Line	:	10577 ROYAL FOREST DR
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77303-2733
Country	:	US
Telephone Number	:	936-217-7215
Fax Number	:

Provider Business Practice Location Address
First Line	:	10577 ROYAL FOREST DR
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77303-2733
Country	:	US
Telephone Number	:	936-217-7215
Fax Number	:

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

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	07/01/2021

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