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NPI Code Detail

MEDICARE: LOREN CLAIRE MARIE PA

MEDICARE: LOREN CLAIRE MARIE 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
1363A00000XPhysician Assistant07529TX

General Provider Information

NPI Number : 1952473324
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOREN CLAIRE MARIE PA
Provider Business Mailing Address
First Line : 3320 OAKWELL CT
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78218-3128
Country : US
Telephone Number : 210-802-4758
Fax Number : 210-802-4758
Provider Business Practice Location Address
First Line : 3320 OAKWELL CT
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78218-3128
Country : US
Telephone Number : 210-829-5180
Fax Number : 210-829-5030
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 08/30/2021

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Directions to “ LOREN CLAIRE MARIE PA” Practice Location

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