Individual
JUAN LARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1202 CORPUS CHRISTI ST., LAREDO, TX 78040-5353
(956) 568-1572
(956) 568-4720
Mailing address
1202 CORPUS CHRISTI ST, LAREDO, TX 78040-5353
(956) 568-1572
(956) 568-4720
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
6758930001
TX
332B00000X
Durable Medical Equipment & Medical Supplies
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Other
Enumeration date
06/06/2013
Last updated
05/21/2021
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