Organization
LA PUERTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISRAEL LOACHAMIN (EXECUTIVE DIRECTOR)
(817) 965-2044
Entity
Organization
Contact information
Practice address
500 WEBSTER AVE, WACO, TX 76706-1163
(254) 301-4062
Mailing address
500 WEBSTER AVE, WACO, TX 76706-1163
(254) 301-4062
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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