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General NPI Number Information
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NPI Number | 1538097365
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Entity Type | Individual
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Provider Name | ERIC LARA GARCIA
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Gender | Male
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Dates
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Enumeration Date | 05/12/2026
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Last Update Date | 05/12/2026
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Provider Practice Location Address
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Address Line | 1653 RIVER RUN STE 101
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City | FORT WORTH
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State | TX
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Zip | 76107-6680
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Country | US
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Telephone | 817-727-4555
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Fax |
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Provider Business Mailing Address
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Address Line | 1650 CANDLER DR APT 17105
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City | BURLESON
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State | TX
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Zip | 76028-3966
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Country | US
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Telephone | 817-727-4555
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number | 261783
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License Number State | TX
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