MARC ANTHONY LARA (NPI# 1720569106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720569106 |
| Entity Type | Individual |
| Full Name | MARC ANTHONY LARA |
| Practice Address |
405 N Cates St Decatur TX 76234-1504 |
| Practice Telephone | 9403933410 |
| Mailing Telephone | 9403933410 |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2018-08-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
405 N CATES ST |
| City | DECATUR |
| State | TX |
| Zip Code | 76234-1504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477102028 | Ursula Eileen Fernandez-plata | Technician | 1221 Cr 4371, Decatur, TX 76234 | 2019-09-06 |
| 1649772377 | Stephanie Jennie Roddenberry | Nurse Practitioner | 2301 S Fm 51 Ste 500, Decatur, TX 76234 | 2018-03-08 |
| 1467731679 | David Gatti Corless | Dentist | 301 W. Main St., Decatur, TX 76234 | 2011-08-05 |
| 1376830067 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 805 W Business Hwy 380, Decatur, TX 76234 | 2011-07-01 |
| 1356667844 | Richard Ryan Ooten | Specialist/Technologist, Other | 239 Harvey Lane, Decatur, TX 76234 | 2010-04-09 |
| 1003049032 | Advanced Gastroenterology Associates, Pa | Internal Medicine | 607 Medical Center Drive, Suite 2600, Decatur, TX 76234 | 2009-08-25 |
| 1831346188 | Rufus John Nelson | Dentist | 1710 S Hwy 51 Ste 20,pmb #176, 1000 W Business Hwy 380, Decatur, TX 76234 | 2008-08-19 |
| 1851558449 | James Lee Hendrick | Counselor | 2304 Fm 51 South, Decatur, TX 76234 | 2008-05-21 |
| 1891964995 | Sheryl A White | Counselor | 1106 E Business Hwy 380, Decatur, TX 76234 | 2008-02-22 |
| 1366625022 | Tower Mutual Holding Company, Inc. | Durable Medical Equipment & Medical Supplies | 206 N. State Street, Decatur, TX 76234 | 2007-12-17 |
| Find all providers in zip 76234 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992321582 | Shelly L. Baldwin | Student in an Organized Health Care Education/Training Program | 1 College Park, Decatur, IL 62521-8512 | 2020-06-19 |
| 1962025197 | Yvonne Hsia | Student in an Organized Health Care Education/Training Program | 2510 Twin Oaks Ct Apt 18, Decatur, IL 62526-5846 | 2020-05-21 |
| 1215567722 | Harley Nicole Moore | Student in an Organized Health Care Education/Training Program | 710 14th Ave Se, Decatur, AL 35601-3314 | 2020-01-23 |
| 1922641398 | Maria Victoria Casaine Rodriguez | Student in an Organized Health Care Education/Training Program | 3435 N Druid Hills Rd Apt M, Decatur, GA 30033-3758 | 2019-10-17 |
| 1487216164 | Manan Nilesh Vyas | Student in an Organized Health Care Education/Training Program | 2532 N Decatur Rd Apt 2218, Decatur, GA 30033-6185 | 2019-07-03 |
| 1285112037 | Zachary Steven Habermaas | Student in an Organized Health Care Education/Training Program | 1266 Brookfield Dr, Decatur, IL 62521-9084 | 2018-08-03 |
| 1760976203 | Thomas Wesley Hodo | Student in an Organized Health Care Education/Training Program | 2793 Autumn Lake Ln, Decatur, GA 30034-3559 | 2018-06-19 |
| 1194234815 | Hans Verkerke | Student in an Organized Health Care Education/Training Program | 2473 Mccurdy Way, Decatur, GA 30033-4820 | 2017-09-26 |
| 1073048104 | Jaylon Christopher Joyner | Student in an Organized Health Care Education/Training Program | 2245 Valley View Pl, Decatur, IL 62522-1367 | 2017-04-26 |
| 1679014831 | Luke Naylor | Student in an Organized Health Care Education/Training Program | 1602 Woodland St Se, Decatur, AL 35601-5242 | 2017-03-20 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.