Individual
LORI B SPORS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
705 WEST MAIN STREET, COPPELL, TX 75019
(972) 304-6400
Mailing address
200 CARRIAGE TRL, WYLIE, TX 75098-8248
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
AP141940
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTHER
MEDICARE MEDICAID AND INSURANCE
TX
Enumeration date
08/02/2019
Last updated
10/21/2024
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