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General NPI Number Information
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NPI Number | 1417012139
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Entity Type | Individual
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Provider Name | CYNTHIA LORENA LARA D.C.
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Gender | Female
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 3819 N EXPRESSWAY STE 2
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City | BROWNSVILLE
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State | TX
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Zip | 78520-9510
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Country | US
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Telephone | 800-404-6050
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Fax | 866-313-3397
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Provider Business Mailing Address
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Address Line | PO BOX 700688
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City | SAN ANTONIO
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State | TX
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Zip | 78270-0688
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Country | US
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Telephone | 210-318-3007
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Fax | 210-468-0682
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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 | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 05404
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License Number State | TX
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