Individual
MARY E LACAZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4801 ALBERTA AVE, EL PASO, TX 79905-2707
(915) 545-6816
(915) 545-6795
Mailing address
PO BOX 9520, EL PASO, TX 79995-9520
(915) 545-6816
(915) 545-6795
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4370
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219536401
—
TX
Enumeration date
09/22/2006
Last updated
08/13/2012
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