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General NPI Number Information
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NPI Number | 1508010117
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Entity Type | Organization
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Legal Business Name | LAREDO LAPB AND CENTER, INC.
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Dates
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Enumeration Date | 11/10/2008
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Last Update Date | 11/10/2008
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Provider Practice Location Address
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Address Line | 2601 CLARK BLVD
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City | LAREDO
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State | TX
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Zip | 78043-2419
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Country | US
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Telephone | 210-379-4599
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Fax | 956-795-4774
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Provider Business Mailing Address
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Address Line | 2601 CLARK BLVD
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City | LAREDO
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State | TX
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Zip | 78043-2419
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Country | US
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Telephone | 210-379-4599
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Fax | 956-795-4774
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARGIE CASTANEDA
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Credential | FNP
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Telephone | 210-379-4599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 200400447322
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License Number State | TX
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