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Micaela Larose
General Practice Physician in Fort Sam Houston, Texas
NPI 1245825108

Micaela Larose is a General Practice Physician based in Fort Sam Houston, TX. Micaela Larose practices in Fort Sam Houston, TX. The NPI Number for Micaela Larose is 1245825108 and holds a License No. U1525 (Texas).

The current practice location address for Micaela Larose is 3551 Roger Brooke Dr, Fort Sam Houston, TX and can be reached out via phone at 210-916-4789 and via fax at 210-916-6654.

Location: 3551 Roger Brooke Dr, Fort Sam Houston, TX, 78234-4504
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1245825108
Provider Name
Micaela Larose
Credential
Provider Entity Type
Individual
Gender
Female
Address
3551 Roger Brooke Dr, Fort Sam Houston, TX, 78234-4504
Phone Number
210-916-4789
Fax Number
210-916-6654
Provider Enumeration Date
03/03/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3551 Roger Brooke Dr
City
Fort Sam Houston
State
Texas
Zip
78234-4504
Phone Number
210-916-4789
Fax Number
210-916-6654
person
Provider Business Mailing Address Details
Address
3551 Roger Brooke Dr
City
Fort Sam Houston
State
Texas
Zip
78234-4504
Phone Number
210-916-4789
Fax Number
210-916-6654
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
U1525 (Texas)
Definition
Definition to come...
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