MEDICARE: LORINE LAGATTA M.D.

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	M4847	TX

General Provider Information

NPI Number	:	1588722201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORINE LAGATTA M.D.

Provider Business Mailing Address
First Line	:	9647 CALMONT WAY
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-5033
Country	:	US
Telephone Number	:	102-968-1052
Fax Number	:

Provider Business Practice Location Address
First Line	:	9647 CALMONT WAY
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-5033
Country	:	US
Telephone Number	:	210-296-8105
Fax Number	:

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

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	09/25/2024

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