Individual
DEBORAH LARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
309 PLANTATION DR, LAKE JACKSON, TX 77566-6142
(979) 418-7165
Mailing address
309 PLANTATION DR, LAKE JACKSON, TX 77566-6142
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2047728
TX
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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