Individual
LACEY SUAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 VIRGINIA DR APT C, WICHITA FALLS, TX 76309-4640
(940) 631-2296
Mailing address
2100 VIRGINIA DR APT C, WICHITA FALLS, TX 76309-4640
(940) 631-2296
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
342606
TX
Other
Enumeration date
06/15/2018
Last updated
06/15/2018
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