Individual
MATTHEW LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18140 SAN PEDRO AVE, SAN ANTONIO, TX 78232-1421
(210) 490-4931
Mailing address
21915 US HIGHWAY 281 N APT 12223, SAN ANTONIO, TX 78258-2657
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
44371
TX
Other
Enumeration date
07/05/2024
Last updated
07/05/2024
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