Lara Pierce, Md Pllc | |
217 W Belknap St Jacksboro TX 76458-2307 | |
(940) 567-8114 | |
(940) 521-5511 |
Full Name | Lara Pierce, Md Pllc |
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Speciality | Family Medicine |
Location | 217 W Belknap St, Jacksboro, Texas |
Authorized Official Name and Position | Jayne Wynne (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 9406319601 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lara Pierce, Md Pllc 217 W Belknap St Jacksboro TX 76458-2307 Ph: (940) 567-8114 | Lara Pierce, Md Pllc 217 W Belknap St Jacksboro TX 76458-2307 Ph: (940) 567-8114 |
NPI Number | 1588268288 |
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Provider Enumeration Date | 11/24/2020 |
Last Update Date | 11/24/2020 |
Medicare PECOS PAC ID | 9436566163 |
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Medicare Enrollment ID | O20210325001192 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588268288 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Lara Marina Pierce |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1518109040 PECOS PAC ID: 9638329444 Enrollment ID: I20121031000558 |
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