Individual
LISA R IBARRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3230 S LOOP 1604 E LOT E4, SAN ANTONIO, TX 78264-9647
(210) 993-7502
Mailing address
3230 S LOOP 1604 E LOT E4, SAN ANTONIO, TX 78264-9647
(210) 993-7502
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
318181
TX
Other
Enumeration date
01/14/2021
Last updated
01/14/2021
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