Provider Demographics
NPI:1790987782
Name:LUNARDON, ALISON CORY WORTMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:CORY WORTMAN
Last Name:LUNARDON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:CORY
Other - Last Name:WORTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3025 N TARRANT PKWY STE 380
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76177-8620
Mailing Address - Country:US
Mailing Address - Phone:817-361-4903
Mailing Address - Fax:817-361-4904
Practice Address - Street 1:3025 N TARRANT PKWY STE 380
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76177
Practice Address - Country:US
Practice Address - Phone:817-361-4903
Practice Address - Fax:817-361-4904
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-03
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0520207V00000X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology