Active NPI
Juan Lara
- Durable Medical Equipment & Medical Supplies
- Laredo, TX
National Provider Identifier
1760820245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 6758930001
- Practice address
- 1202 Corpus Christi St.
Laredo, TX 78040-5353 - Phone
- (956) 568-1572
- Fax
- (956) 568-4720
- NPI assigned
- Jun 6, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Durable Medical Equipment & Medical Supplies | 332B00000X | 6758930001 | TX | Primary |
Addresses
Primary practice location
1202 Corpus Christi St.
Laredo, TX 78040-5353
Mailing address
1202 Corpus Christi St
Laredo, TX 78040-5353
Phone (956) 568-1572
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6758930001 | TX | MD | Durable Medical Equipment & Medical Supplies |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Juan Lara | Durable Medical Equipment & Medical Supplies | Current | Accepting new patients |
Locations
1202 Corpus Christi St
Laredo, TX 78040
Phone (956) 568-1572
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621555200000",
"number": "1760820245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1202 CORPUS CHRISTI ST",
"city": "LAREDO",
"state": "TX",
"postal_code": "780405353",
"telephone_number": "956-568-1572",
"fax_number": "956-568-4720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1202 CORPUS CHRISTI ST.",
"city": "LAREDO",
"state": "TX",
"postal_code": "780405353",
"telephone_number": "956-568-1572",
"fax_number": "956-568-4720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARA",
"first_name": "JUAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-06",
"last_updated": "2021-05-21",
"certification_date": "2021-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "TX",
"license": "6758930001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Laredo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.