Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 1018950 | TX |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 1018950 | TX |
NPI | 1417545062 |
---|---|
Provider Name | Mr. Lawrence Remy |
First Address | San Antonio, TX 78212-5601 |
Second Address | San Antonio, TX 78212-5601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2021 |
Last Update Date | 01/06/2021 |