| Sergio Lara Md Pa | |
|
2222 W 24th St Plainview TX 79072-1802 | |
| (806) 293-5113 | |
| (806) 296-7990 |
| Full Name | Sergio Lara Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 2222 W 24th St, Plainview, Texas |
| Authorized Official Name and Position | Sergio A Lara (PHYSICIAN) |
| Authorized Official Contact | 8062935113 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sergio Lara Md Pa 2222 W 24th St Plainview TX 79072-1802 Ph: (806) 293-5113 | Sergio Lara Md Pa 2222 W 24th St Plainview TX 79072-1802 Ph: (806) 293-5113 |
| NPI Number | 1205070398 |
|---|---|
| Provider Enumeration Date | 04/21/2009 |
| Last Update Date | 08/19/2009 |
| Medicare PECOS PAC ID | 7315095478 |
|---|---|
| Medicare Enrollment ID | O20090429000023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205070398 | NPI | - | NPPES |
| 202323601 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | L3371 (Texas) | Primary |
| Provider Name | Sergio A Lara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578639621 PECOS PAC ID: 1557324951 Enrollment ID: I20041106000195 |
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