Provider Demographics
NPI:1275724908
Name:DORMAN, LOIS (CMA)
Entity Type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:
Last Name:DORMAN
Suffix:
Gender:F
Credentials:CMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 WALTER REED BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042
Mailing Address - Country:US
Mailing Address - Phone:972-272-0282
Mailing Address - Fax:972-276-6492
Practice Address - Street 1:777 WALTER REED BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042
Practice Address - Country:US
Practice Address - Phone:972-272-0282
Practice Address - Fax:972-276-6492
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0036877246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist