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Individual

CHRISTINA MARIE LASCANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
5750 W VICKERY BLVD STE 104, FORT WORTH, TX 76107-7448
(817) 732-2878
Mailing address
5750 W VICKERY BLVD STE 104, FORT WORTH, TX 76107-7448
(817) 732-2878

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA11416
TX

Other

Enumeration date
08/31/2017
Last updated
02/23/2022
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