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General NPI Number Information
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NPI Number | 1982807749
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Entity Type | Organization
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Legal Business Name | ALICE LAZARESCU
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Dates
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Enumeration Date | 06/08/2007
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 6009 W PARKER RD STE 149 PMB 310
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City | PLANO
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State | TX
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Zip | 75093-8121
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Country | US
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Telephone | 972-250-2023
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Fax | 972-250-2086
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Provider Business Mailing Address
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Address Line | 6009 W PARKER RD STE 149 PMB 310
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City | PLANO
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State | TX
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Zip | 75093-8121
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Country | US
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Telephone | 972-250-2023
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Fax | 972-250-2086
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Authorized Official
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Title or Position | ACCOUNT MANAGER
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Name | DENISE L STEICHEN
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Credential |
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Telephone | 972-250-2023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | L5427
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License Number State | TX
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