Most Relevant Information
Provider Data
| NPI Number: | 1003587783 |
| Provider Name: | JAIME ENRIQUE LARA CPHT |
| Entity Type: | Individual |
| Taxonomy Code: | 183700000X |
| Specialty: | Pharmacy Technician |
| License Number: | 181896 |
Most Important Dates
| Enumeration Date: | 09/23/2021 |
| Last Updated: | 09/23/2021 |
Provider Practice Location
1219 MATAMOROS ST
LAREDO
TX
780405069
Practice Location Phone/Fax
| Phone: | 9567264512 |
| Fax: |
Provider Mailing Location
1219 MATAMOROS ST
LAREDO
TX
780405069
Provider Mailing Phone/Fax
| Phone: | 9567264512 |
| Fax: |