Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TC1900X | Counseling Psychologist | 22876 | TX |
N | 103TS0200X | School Psychologist | 30424 | TX |
NPI | 1114088978 |
---|---|
Provider Name | Dr. Joe Luis Lerma |
First Address | Corpus Christi, TX 78411-4318 |
Second Address | Corpus Christi, TX 78411-4318 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R57849 | (02) | TX |