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1740701002
PASSISD LAOVEERAVAT
LUBBOCK, TX
NPI
1740701002
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: TX BP10059576)
Enumeration Date
2017-06-27
Last Update Date
2022-07-21
Business Address
PASSISD LAOVEERAVAT md
3601 4TH ST # MS 9410
LUBBOCK, TX 79430-0002
Phone number: 806-743-3381
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Mailing Address
PASSISD LAOVEERAVAT md
3601 4TH ST # MS 9410
LUBBOCK, TX 79430-0002
Phone number: 806-743-3381
Copy
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