Individual
DAMIAN G LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
622 W STATE HIGHWAY 71 STE 102, BASTROP, TX 78602-4234
(512) 308-4311
Mailing address
6210 E HWY 290, AUSTIN, TX 78723-1142
(512) 308-4311
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
T3503
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/18/2018
Last updated
06/09/2022
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