Provider Demographics
NPI:1912944034
Name:LORIMER, JODY H (MD)
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:H
Last Name:LORIMER
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:PO BOX 342
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-0342
Mailing Address - Country:US
Mailing Address - Phone:817-229-9538
Mailing Address - Fax:
Practice Address - Street 1:8950 N TARRANT PKWY
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-8465
Practice Address - Country:US
Practice Address - Phone:817-281-7277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC116734207P00000X
TXM4319207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX190112602Medicaid
TXP00379867OtherRAILROAD
TX8W1781OtherBCBS
TX190112601Medicaid
TX8J3110Medicare PIN
TX8L26310Medicare PIN
TX190112602Medicaid