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General NPI Number Information
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NPI Number | 1487263653
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Entity Type | Individual
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Provider Name | JULIA ANN LACY DMD
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Gender | Female
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Dates
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Enumeration Date | 07/23/2020
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Last Update Date | 04/26/2024
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Provider Practice Location Address
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Address Line | 8210 FLOYD CURL DR # 8122
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3923
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Country | US
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Telephone | 210-450-3715
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Fax |
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Provider Business Mailing Address
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Address Line | 6824 TERRA RYE
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City | SAN ANTONIO
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State | TX
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Zip | 78240-2757
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Country | US
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Telephone | 262-215-8072
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | ETN784
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License Number State | TX
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