Individual
STEVEN LARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSFA/CST
Contact information
Practice address
100 RUSTY RUN, BOERNE, TX 78006-6422
(210) 833-9204
Mailing address
100 RUSTY RUN, BOERNE, TX 78006-6422
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
140453
TX
Other
Enumeration date
07/08/2013
Last updated
07/08/2013
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