Individual
AMY LEE LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4444 CORONA DR STE 107, CORPUS CHRISTI, TX 78411-4374
(361) 400-1886
Mailing address
4444 CORONA DR STE 107, CORPUS CHRISTI, TX 78411-4374
(361) 400-1886
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
233511
TX
Other
Enumeration date
04/15/2021
Last updated
04/15/2021
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