Individual
JOHN CLINT LASITER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4450 SUNSET DR, SAN ANGELO, TX 76901-5611
(325) 658-1511
(325) 659-0180
Mailing address
PO BOX 22000, SAN ANGELO, TX 76902-7200
(325) 658-1511
(325) 659-0180
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
N4538
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8CG991
BCBS
TX
Enumeration date
09/11/2006
Last updated
09/08/2010
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