Provider Demographics
NPI:1225170582
Name:MYERS, LORIE (OTR)
Entity Type:Individual
Prefix:
First Name:LORIE
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 HERITAGE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-7163
Mailing Address - Country:US
Mailing Address - Phone:903-868-9700
Mailing Address - Fax:903-870-1425
Practice Address - Street 1:1711 HERITAGE PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7163
Practice Address - Country:US
Practice Address - Phone:903-868-9700
Practice Address - Fax:903-870-1425
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107373225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T0034OtherBLUECROSS BLUESHIELD
TX107373OtherSTATE ID