Provider Demographics
NPI:1275526998
Name:OST, LOREN (MD)
Entity Type:Individual
Prefix:
First Name:LOREN
Middle Name:
Last Name:OST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1367
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75483-1367
Mailing Address - Country:US
Mailing Address - Phone:903-439-6500
Mailing Address - Fax:903-438-0164
Practice Address - Street 1:113 AIRPORT RD
Practice Address - Street 2:SUITE 302
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-2193
Practice Address - Country:US
Practice Address - Phone:903-439-6500
Practice Address - Fax:903-438-0164
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1380208800000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX296561801Medicaid
TXTXB142221Medicare PIN
TXG93565Medicare UPIN
TXTXB142221Medicare PIN