Gordon, Lori Lynn
Gordon, Lori Lynn is an individual health care provider with primary practice located at 1420 8Th Avenue, Suite 103 , Fort Worth TX 76104-4138. She recently has only one registered license in Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, which is considered as her primary health care specialty. Gordon, Lori Lynn can be contacted via phone (817) 924-9002.Contact Information
Primary practice address
1420 8Th Avenue, Suite 103
Fort Worth TX 76104-4138
Phone: (817) 924-9002
Fax: (817) 924-9960
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Colon & Rectal Surgery | 208C00000X | J6468 | Texas |
Profile Details
| NPI number | 1053386045 |
|---|---|
| LBN Legal business name | Gordon, Lori Lynn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 22nd, 2006 |
| Last updated | Sep 30th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053386045 | NPPES |
| Texas | MEDICAID | 213903201 |
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