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General NPI Number Information
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NPI Number | 1760439335
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Entity Type | Individual
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Provider Name | LUCIANO JO SARABOSING JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2108 N LAURENT ST
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City | VICTORIA
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State | TX
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Zip | 77901-5451
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Country | US
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Telephone | 361-578-3604
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Fax | 361-576-4397
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Provider Business Mailing Address
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Address Line | 806 CHARLESTON DR
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City | VICTORIA
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State | TX
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Zip | 77904-3822
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Country | US
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Telephone | 361-574-8553
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Fax | 361-574-8583
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | J7177
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License Number State | TX
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