Individual
LISA MARIE LARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
4707 CASA BLANCA RD, LAREDO, TX 78041-7669
(830) 448-8507
Mailing address
4707 CASA BLANCA RD, LAREDO, TX 78041-7669
(830) 448-8507
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
229989
TX
Other
Enumeration date
08/09/2018
Last updated
08/09/2018
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