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Organization
LGUC PLLC
Active
Organization
LGUC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALYSON BEISERT (CREDENTIALING ADMINISTRATOR)
(979) 968-8493
Entity
Organization
Contact information
Practice address
1253 N VON MINDEN ST, LA GRANGE, TX 78945-1262
(979) 968-8493
(979) 968-6388
Mailing address
1253 N VON MINDEN ST, LA GRANGE, TX 78945-1262
(979) 968-8493
(979) 968-6388
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/13/2019
Last updated
06/17/2019
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