Individual
DR. DOMINGO A LARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1303 MCCULLOUGH AVE, 138, SAN ANTONIO, TX 78212-5609
(210) 225-3330
(210) 497-8189
Mailing address
1303 MCCULLOUGH AVE, 138, SAN ANTONIO, TX 78212-5609
(210) 225-3330
(210) 497-8189
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
G6550
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114716703
—
TX
Enumeration date
07/12/2006
Last updated
06/19/2008
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