Damian G Lara, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

T3503 Issued in TX

Practice address

622 W State Highway 71 Ste 102
Bastrop, TX 78602-4234

Phone

(512) 308-4311

NPI assigned

Jun 18, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Central Texas Community Health Centers

  • Family Medicine Physician
  • Austin, TX
  • NPI 1427882091
  Medicare reassignment NPD
• Central Texas Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Austin, TX
  • NPI 1598591414
  NPD
• South Austin Family Practice Clinic, PLLC

  • Family Medicine Physician
  • Austin, TX
  • NPI 1235130592
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1124512702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 E HWY 290",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787231142",
            "telephone_number": "512-308-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W STATE HIGHWAY 71 STE 102",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786024234",
            "telephone_number": "512-308-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARA",
        "first_name": "DAMIAN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-18",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T3503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Kowalski
• Dianna Kay Kuehner, PSY.D
• Robert Ray Labarbera
• Kevin Lacke, DPT, CSCS
• Lakeside Hospital at Bastrop, LTD
• Matthew Lassen, DMD
• Laurier a. Vocal
• Kyoung Lee
• Sammy Lerma III, M.D.
• Let'S Talk, Bastrop, PLLC

• Family Medicine Physician in Bastrop, TX
• Providers in Bastrop, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.