Individual
JAIME ENRIQUE LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
1219 MATAMOROS ST, LAREDO, TX 78040-5069
(956) 726-4512
Mailing address
1219 MATAMOROS ST, LAREDO, TX 78040-5069
(956) 726-4512
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
181896
TX
Other
Enumeration date
09/23/2021
Last updated
09/23/2021
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