Provider Demographics
NPI:1649095381
Name:LOHRSTORFER, ALEXA ANNE
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:ANNE
Last Name:LOHRSTORFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16318 ELK HOLLOW ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-1360
Mailing Address - Country:US
Mailing Address - Phone:512-517-6565
Mailing Address - Fax:
Practice Address - Street 1:601B LEAH AVE
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7849
Practice Address - Country:US
Practice Address - Phone:512-392-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1179841363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty