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General NPI Number Information
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NPI Number | 1467405050
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Entity Type | Individual
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Provider Name | LAWRENCE NUNEZ TERUEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 155 CALLE PORTAL SUITE 600
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-2900
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Country | US
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Telephone | 520-458-4919
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 93
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City | SIERRA VISTA
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State | AZ
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Zip | 85636-0093
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Country | US
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Telephone | 520-458-4919
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Fax |
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 34998
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License Number State | AZ
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