Provider Demographics
NPI:1548761554
Name:DORE, LUCIA C (FNP)
Entity Type:Individual
Prefix:
First Name:LUCIA
Middle Name:C
Last Name:DORE
Suffix:
Gender:F
Credentials:FNP
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 864245
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75086-4245
Mailing Address - Country:US
Mailing Address - Phone:214-713-7520
Mailing Address - Fax:
Practice Address - Street 1:1530 NORTHAVEN DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-1647
Practice Address - Country:US
Practice Address - Phone:214-713-7520
Practice Address - Fax:214-602-9188
Is Sole Proprietor?:No
Enumeration Date:2018-02-25
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134482363LF0000X
TX376K00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No376K00000XNursing Service Related ProvidersNurse's Aide