Individual
AMANDA M LAZCANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
302 KINGS HWY STE 208, BROWNSVILLE, TX 78521-4225
(956) 550-8200
(956) 550-8133
Mailing address
3454 BURGUNDY DR, BROWNSVILLE, TX 78526-1136
(956) 982-1191
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
18774
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8T3165
BCBS OF TEXAS
TX
Enumeration date
10/26/2006
Last updated
07/08/2007
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