Individual
LARRSHAR V WINDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
13915 BURNET RD, AUSTIN, TX 78728-6517
(512) 996-9559
Mailing address
4605 GREEN MEADOW ST, KILLEEN, TX 76549-5622
(254) 366-7455
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
226847
TX
Other
Enumeration date
10/05/2018
Last updated
10/05/2018
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