Individual
LARA BASHOURA
Active
Individual
LARA BASHOURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
M0349
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172796801
—
TX
01
—
172796802
MEDICAID - CSHCN
TX
01
—
8P2675
BCBS
TX
01
—
P00205009
RR MEDICARE
TX
Enumeration date
09/22/2006
Last updated
07/01/2021
Update your record
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