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General NPI Number Information
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NPI Number | 1265525554
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Entity Type | Individual
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Provider Name | LARA CLINTON D.C.
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Gender | Female
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Dates
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Enumeration Date | 10/01/2006
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Last Update Date | 12/08/2010
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Provider Practice Location Address
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Address Line | 4654 HIGHWAY 6 N SUITE 305
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City | HOUSTON
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State | TX
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Zip | 77084-2868
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Country | US
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Telephone | 281-855-2277
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Fax | 281-855-2292
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Provider Business Mailing Address
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Address Line | 4654 HIGHWAY 6 N SUITE 305
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City | HOUSTON
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State | TX
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Zip | 77084-2868
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Country | US
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Telephone | 281-855-2277
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Fax | 281-855-2292
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 6341
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License Number State | TX
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