Provider Demographics
NPI:1346463619
Name:LORI D STETLER M.D. PA
Entity Type:Organization
Organization Name:LORI D STETLER M.D. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PA
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:D
Authorized Official - Last Name:STETLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-631-7546
Mailing Address - Street 1:8201 PRESTON RD STE 350
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-6225
Mailing Address - Country:US
Mailing Address - Phone:214-631-7546
Mailing Address - Fax:214-631-8546
Practice Address - Street 1:8201 PRESTON RD STE 350
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-6225
Practice Address - Country:US
Practice Address - Phone:214-631-7546
Practice Address - Fax:214-631-8546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8436207N00000X
TXK2329207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A5780OtherBCBS
TX8A5781OtherBCBS SINGER
TX8263M0Medicare ID - Type UnspecifiedSTETLER MEDICARE
TXH09278Medicare UPIN
TXE66402Medicare UPIN
TX8263M1Medicare ID - Type UnspecifiedSINGER MEDICARE
TX00074RMedicare ID - Type UnspecifiedGRP MEDICARE