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General NPI Number Information
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NPI Number | 1871818724
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Entity Type | Organization
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Legal Business Name | JAVIER LAFUENTE MD PA
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Dates
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Enumeration Date | 04/05/2010
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Last Update Date | 04/05/2010
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Provider Practice Location Address
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Address Line | 21402 PROVINCIAL BLVD
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City | KATY
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State | TX
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Zip | 77450-7587
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Country | US
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Telephone | 281-203-0600
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Fax |
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Provider Business Mailing Address
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Address Line | 21402 PROVINCIAL BLVD
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City | KATY
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State | TX
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Zip | 77450-7587
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Country | US
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Telephone | 281-203-0600
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAVIER LAFUENTE
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Credential | MD
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Telephone | 291-203-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | J2890
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License Number State | TX
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