Organization
LAREDO DERMATOLOGY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRENE GARCIA (BILLING DIRECTOR)
(956) 726-1646
Entity
Organization
Contact information
Practice address
121 CALLE DEL NORTE, SUITE 102, LAREDO, TX 78041-9133
(956) 726-1646
(956) 795-4764
Mailing address
121 CALLE DEL NORTE, SUITE 102, LAREDO, TX 78041-9133
(956) 726-1646
(956) 795-4764
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0068HZ
BCBS TX
TX
05
—
151039801
—
TX
Enumeration date
03/02/2007
Last updated
12/29/2011
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