Individual
JUDITH PANERGO LAZOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1901 SW H K DODGEN LOOP BLDG 300, TEMPLE, TX 76502-1814
(254) 724-5437
(254) 724-7597
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
N6450
TX
2080P0202X
Pediatric Cardiology Physician
Primary
N6450
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689992521
—
TX
Enumeration date
05/16/2010
Last updated
10/01/2020
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