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Individual

ROBERTO B. D'LORM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
GNP-BC

Contact information

Practice address
4032 OUTPOST TRCE, LAGO VISTA, TX 78645-6456
(512) 364-8494
(512) 267-1362
Mailing address
4032 OUTPOST TRCE, LAGO VISTA, TX 78645-6456
(512) 364-8494
(512) 267-1362

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
672526
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
672526
GNP LICENSE
TX
Enumeration date
02/26/2008
Last updated
01/31/2011
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