Most Relevant Information
Provider Data
| NPI Number: | 1003565813 |
| Provider Name: | DEVEN LARISCH |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/20/2022 |
| Last Updated: | 03/20/2022 |
Provider Practice Location
2401 S 31ST ST
TEMPLE
TX
765080001
Practice Location Phone/Fax
| Phone: | 2547242111 |
| Fax: |
Provider Mailing Location
2401 S 31ST ST
TEMPLE
TX
765080001
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |