Provider Demographics
NPI:1427316058
Name:NORTH, LORENA RODRIGUEZ (MD)
Entity type:Individual
Prefix:
First Name:LORENA
Middle Name:RODRIGUEZ
Last Name:NORTH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LORENA
Other - Middle Name:RODRIGUEZ
Other - Last Name:NORTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LORENA B RODRIGUEZ
Mailing Address - Street 1:3551 ROGER BROOKE DR
Mailing Address - Street 2:
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4504
Mailing Address - Country:US
Mailing Address - Phone:210-539-9582
Mailing Address - Fax:
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-539-9582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101255567207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine