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1720685993
LACE THOMAS BUSBY
SAN ANTONIO, TX
NPI
1720685993
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TX 1002899)
Enumeration Date
2020-10-01
Last Update Date
2020-10-01
Business Address
Mr. LACE THOMAS BUSBY
1434 E SONTERRA BLVD STE 206
SAN ANTONIO, TX 78258-4973
Phone number: 210-402-3456
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Mailing Address
Mr. LACE THOMAS BUSBY
20523 CREEK RIV
SAN ANTONIO, TX 78259-2083
Phone number: 270-627-0474
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