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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 13 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1053386045 NPPES
Texas MEDICAID 213903201

Popular Providers