Healthcare Provider Details
I. General information
NPI: 1265282941
Provider Name (Legal Business Name): MRS. LALI GEORGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/25/2024
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10807 PERRIN BEITEL RD STE 300
SAN ANTONIO TX
78217-3144
US
IV. Provider business mailing address
10615 WELSH VLY
SAN ANTONIO TX
78254-5953
US
V. Phone/Fax
- Phone: 210-245-7862
- Fax:
- Phone: 210-633-7060
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 1059952 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 1059952 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: