Provider Demographics
NPI:1528073699
Name:NAGLIERI, LORI MICHELLE (MD)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:MICHELLE
Last Name:NAGLIERI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7011 RIBELIN RANCH DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-8585
Mailing Address - Country:US
Mailing Address - Phone:512-345-7436
Mailing Address - Fax:512-346-7436
Practice Address - Street 1:7011 RIBELIN RANCH DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750
Practice Address - Country:US
Practice Address - Phone:512-345-7436
Practice Address - Fax:512-346-7436
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3570207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX156657205Medicaid
TX156657206Medicaid
TXL3570OtherTX MEDICAL LICENSE
TX60122929OtherDPS
TXBB7777317OtherDEA
TXP00000863Medicare PIN
TX8A5544Medicare PIN
TXBB7777317OtherDEA
TXL3570OtherTX MEDICAL LICENSE