Provider Demographics
NPI:1366879694
Name:PRIFTE, LORA BROWN (PA-C)
Entity type:Individual
Prefix:
First Name:LORA
Middle Name:BROWN
Last Name:PRIFTE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LORA
Other - Middle Name:KELLY
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:7716 LAKE JUNE RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75217-1650
Mailing Address - Country:US
Mailing Address - Phone:214-398-8801
Mailing Address - Fax:
Practice Address - Street 1:7716 LAKE JUNE RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-1650
Practice Address - Country:US
Practice Address - Phone:214-398-8801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant