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NPI Code Detail

MEDICARE: LARA CHRISTINE MONTFORT MSN, APRN, AGNP-C

MEDICARE: LARA CHRISTINE MONTFORT MSN, APRN, AGNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12086S0122XPlastic and Reconstructive Surgery Physician1228882TX

General Provider Information

NPI Number : 1114873312
Entity Type Code : Individual
Provider Name (Legal Business Name) : LARA CHRISTINE MONTFORT MSN, APRN, AGNP-C
Provider Business Mailing Address
First Line : 2905 SAN GABRIEL ST STE 100
Second Line :
City : AUSTIN
State : TX
Zip : 78705-3548
Country : US
Telephone Number : 512-815-0123
Fax Number :
Provider Business Practice Location Address
First Line : 2905 SAN GABRIEL ST STE 100
Second Line :
City : AUSTIN
State : TX
Zip : 78705-3548
Country : US
Telephone Number : 512-815-0123
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2026
Last Update Date : 03/09/2026

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Directions to “ LARA CHRISTINE MONTFORT MSN, APRN, AGNP-C” Practice Location

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