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Organization

LACEY L. AGUERO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LACEY LILLIAN AGUERO LSA (LICENSED SURGICAL ASSISTANT)
(210) 639-3353
Entity
Organization

Contact information

Practice address
6407 COUGAR VLG, SAN ANTONIO, TX 78242-2466
(210) 639-3353
(210) 233-8672
Mailing address
6407 COUGAR VLG, SAN ANTONIO, TX 78242-2466
(210) 639-3112
(210) 233-8672

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SA00674
TEXAS MEDICAL BOARD
TX
Enumeration date
04/06/2017
Last updated
10/13/2018
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