Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 16902 | LA |
NPI | 1053334185 |
---|---|
Provider Name | Tlaloc S Alferez |
First Address | Luling, LA 70070-4349 |
Second Address | Luling, LA 70070-4349 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 08/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1362077 | (05) | LA |
B63619 | (02) |