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Organization
LORI I GAGNON MD PA
Active
Organization
LORI I GAGNON MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORI I GAGNON MD (OWNER)
(830) 258-7185
Entity
Organization
Contact information
Practice address
260 CULLY DR, KERRVILLE, TX 78028-5950
(830) 258-7383
(830) 258-7055
Mailing address
260 CULLY DR, KERRVILLE, TX 78028-5950
(830) 258-7383
(830) 258-7055
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039NX
BC GRP
—
05
—
184195901
—
TX
01
—
184196701
MCD INDV
—
01
—
8F4161
MCR INDV
TX
01
—
8W5070
BC INDV
—
01
—
DF5642
RAILROAD MCR GRP
—
01
—
P00375637
RAILROAD INDV
—
Enumeration date
08/31/2006
Last updated
12/30/2013
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