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General NPI Number Information
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NPI Number | 1588268288
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Entity Type | Organization
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Legal Business Name | LARA M. PIERCE, MD PLLC
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Dates
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Enumeration Date | 11/24/2020
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 217 W BELKNAP ST
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City | JACKSBORO
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State | TX
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Zip | 76458-2307
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Country | US
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Telephone | 940-567-8114
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Fax | 940-521-5511
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Provider Business Mailing Address
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Address Line | 217 W BELKNAP ST
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City | JACKSBORO
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State | TX
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Zip | 76458-2307
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Country | US
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Telephone | 940-210-9899
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | JAYNE WYNNE
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Credential |
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Telephone | 940-631-9601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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