Healthcare Provider Details

I. General information

NPI: 1689961336
Provider Name (Legal Business Name): LAFAY ARLENE BRYAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2011
Last Update Date: 07/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 DORA ST
SAN ANTONIO TX
78212-1516
US

IV. Provider business mailing address

302 DORA ST
SAN ANTONIO TX
78212-1516
US

V. Phone/Fax

Practice location:
  • Phone: 210-644-8000
  • Fax: 210-644-8025
Mailing address:
  • Phone: 210-644-8000
  • Fax: 210-644-8025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number686873
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: