Organization
CARLOS MANRIQUE DE LARA MDPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLOS MANRIQUE DE LARA MD (MEDICAL DIRECTOR)
(956) 661-9000
Entity
Organization
Contact information
Practice address
2518 W TRENTON RD, EDINBURG, TX 78539-8070
(956) 661-9000
(956) 686-7833
Mailing address
2518 W TRENTON RD, EDINBURG, TX 78539-8070
(956) 661-9000
(956) 686-7833
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173356002
—
TX
Enumeration date
02/17/2006
Last updated
06/10/2008
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