Provider Demographics
NPI:1134207681
Name:LOTT, GENE ALLEN (DC)
Entity type:Individual
Prefix:DR
First Name:GENE
Middle Name:ALLEN
Last Name:LOTT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:6721 TELEPHONE RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76135-2912
Mailing Address - Country:US
Mailing Address - Phone:817-238-9200
Mailing Address - Fax:817-238-9240
Practice Address - Street 1:6721 TELEPHONE RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:TX
Practice Address - Zip Code:76135-2912
Practice Address - Country:US
Practice Address - Phone:817-238-9200
Practice Address - Fax:817-238-9240
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6827111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU91833Medicare UPIN