MRS. LORI A STACKOW (NPI# 1467449835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467449835 |
| Entity Type | Individual |
| Full Name | MRS. LORI A STACKOW |
| Other Name | LORI A RUDDEROW |
| Credential | PAC |
| Practice Address |
6400 Fannin St Ste 2800 Houston TX 77030-1534 |
| Mailing Address |
6400 Fannin St Ste 2070 Houston TX 77030-1541 |
| Practice Telephone | 7137047100 |
| Practice Fax Number | 7137041262 |
| Mailing Telephone | 7137046731 |
| Mailing Fax Number | 7137046889 |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2017-03-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA10687 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 004385800 | 05 | |
| WA | 8434896 | 05 | |
| TX | 153449704 | 05 | |
| WA | DEPT OF LABOR AND INDUSTR | 49008 | 01 |
| ID | REGENCE BS OF ID | 000010017182 | 01 |
| ID | BLUE CROSS OF ID | PAJB6 | 01 |
| DEEIOC | 601417200 | 01 |
| Street Address |
6400 FANNIN ST STE 2800 |
| City | HOUSTON |
| State | TX |
| Zip Code | 77030-1534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194721480 | Jose M Diaz | Psychiatry & Neurology | 6400 Fannin St Ste 2800, Houston, TX 77030-1534 | 2005-06-22 |
| 1588283147 | Dallas Sheinberg | Student in an Organized Health Care Education/Training Program | 6400 Fannin St Ste 2800, Houston, TX 77030-1534 | 2020-04-14 |
| 1770102865 | Ankush Chandra | Student in an Organized Health Care Education/Training Program | 6400 Fannin St Ste 2800, Houston, TX 77030-1534 | 2020-04-09 |
| 1952944142 | Alicia H. Roth | Nurse Practitioner | 6400 Fannin St Ste 2800, Houston, TX 77030-1534 | 2019-10-21 |
| 1255999686 | Nicole Rangel Gutierrez | Registered Nurse | 6400 Fannin St Ste 2800, Houston, TX 77030 | 2019-05-31 |
| 1265096317 | Ut Physicians | Neurological Surgery | 6400 Fannin St Ste 2800, Houston, TX 77030-1534 | 2019-04-24 |
| 1306308853 | Duncan Trimble | Student in an Organized Health Care Education/Training Program | 6400 Fannin St Ste 2800, Houston, TX 77030-1534 | 2019-04-03 |
| 1730641663 | Laura Ann Zima | Student in an Organized Health Care Education/Training Program | 6400 Fannin St Ste 2800, Houston, TX 77030-1534 | 2019-04-01 |
| 1407317860 | Shivani Bindal | Student in an Organized Health Care Education/Training Program | 6400 Fannin St Ste 2800, Houston, TX 77030-1534 | 2019-03-28 |
| 1750840872 | Jerah Leshell Stanford | Nurse Practitioner | 6400 Fannin St Ste 2800, Houston, TX 77030-1534 | 2019-03-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770852 | Mchaji Celestaine | Pharmacist | Medvamc 2002 Holcombe Blvd, Outpatient Pharmacy, Houston, TX 77030 | 2020-11-04 |
| 1730702598 | Christopher A Mcmillian | Student in an Organized Health Care Education/Training Program | Houston Methodist Department of Surgery, 6550 Fannin St., Smith Tower 1661, Houston, TX 77030 | 2020-05-27 |
| 1245852698 | Mostafa Hotait | Student in an Organized Health Care Education/Training Program | 7200 Cambridge Street 9a, Houston, TX 77030 | 2020-05-08 |
| 1790307288 | Ayushi Jayesh Shah | Student in an Organized Health Care Education/Training Program | 6560 Fannin St, Department of Neurology, Houston Method, Suite 802, Scurlock. 8thfloor, Houston, TX 77030 | 2020-05-07 |
| 1932720836 | Vera Whole Health Wa, PC | Clinic/Center | 6620 Main St, 12th Flr, Ste 1225, Houston, TX 77030 | 2020-05-01 |
| 1548881808 | Mobitz Heart and Rhythm Center Pllc | Internal Medicine | Scurlock Tower, 6560 Fannin St., Houston, TX 77030 | 2020-04-28 |
| 1710516513 | Thomas Chi Han Lu | Student in an Organized Health Care Education/Training Program | 6431 Fannin Street, Msb 3.151, Houston, TX 77030 | 2020-04-03 |
| 1063041085 | Kevin Tang | Student in an Organized Health Care Education/Training Program | 7200 Cambridge., Bcm 903, Suite A10.202, Houston, Texas, TX 77030 | 2020-04-02 |
| 1831728898 | Taylor Renbarger | Student in an Organized Health Care Education/Training Program | 6431 Fannin St Suite Jjl 431, Houston, TX 77030 | 2020-04-02 |
| 1972131423 | Sindhu R Rao | Student in an Organized Health Care Education/Training Program | 7200 Cambridge Street, 9th Floor, Suite 9a, Houston, TX 77030 | 2020-03-31 |
| Find all providers in zip 77030 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396345443 | Avery Rhodes Schwartz | Physician Assistant | 2206 Latexo Dr, Houston, TX 77018-1717 | 2020-10-28 |
| 1881291938 | Christine Nicole Nott | Physician Assistant | 13325 Hargrave Rd # 240, Houston, TX 77070-4539 | 2020-10-01 |
| 1306453659 | Christine Michelle Serewis - Pond | Physician Assistant | 950 Threadneedle St # 282, Houston, TX 77079-2925 | 2020-09-29 |
| 1902412828 | Chen-ho Yang | Physician Assistant | 1818 Memorial Dr Ste 200, Houston, TX 77007-8383 | 2020-09-16 |
| 1437769833 | Aviva Tziporah Rogozen | Physician Assistant | 4550 N Braeswood Blvd Apt 331, Houston, TX 77096-2883 | 2020-07-31 |
| 1417575671 | Harmeet Kaur | Physician Assistant | 9601 Jones Rd Ste 238, Houston, TX 77065-4774 | 2020-07-13 |
| 1780201939 | Evelyn Oliva | Physician Assistant | 4943 Brenner St, Houston, TX 77022-2536 | 2020-07-02 |
| 1093330722 | Stephanie Kochuparambil | Physician Assistant | 2630 Bissonnet St Apt 5213, Houston, TX 77005-1571 | 2020-06-09 |
| 1376171587 | Samad Syed Ali | Physician Assistant | 12702 Morning Glory Meadow Ln, Houston, TX 77089-1551 | 2020-04-01 |
| 1235765660 | Samantha Salcedo | Physician Assistant | 6651 Main St Ste 1420, Houston, TX 77030-2351 | 2020-03-17 |
| Find all providers in HOUSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.