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Individual

LISSETTE CARRASCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
11124 WURZBACH RD STE 100, SAN ANTONIO, TX 78230-2440
(210) 615-5242
Mailing address
11124 WURZBACH RD STE 100, SAN ANTONIO, TX 78230-2440
(210) 615-5242

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
308565
TX

Other

Enumeration date
09/12/2018
Last updated
09/12/2018
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