=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821960287
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | REMA LARA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/23/2025
-----------------------------------------------------
Last Update Date | 09/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1706 W SOUTH LOOP
-----------------------------------------------------
City | STEPHENVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76401-5010
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 254-968-4174
-----------------------------------------------------
Fax | 254-968-6001
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 750 N COMMONS DR STE 200
-----------------------------------------------------
City | AURORA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60504-8025
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-303-5380
-----------------------------------------------------
Fax | 630-303-5385
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 237700000X
-----------------------------------------------------
Taxonomy Name | Hearing Instrument Specialist
-----------------------------------------------------
License Number | 80860
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------