Provider Demographics
NPI:1659834703
Name:LAGARE, MARILEX E (APRN)
Entity Type:Individual
Prefix:
First Name:MARILEX
Middle Name:E
Last Name:LAGARE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 E SAVANNAH AVE # 203
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1241
Mailing Address - Country:US
Mailing Address - Phone:956-686-7611
Mailing Address - Fax:
Practice Address - Street 1:2300 N 47TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-3657
Practice Address - Country:US
Practice Address - Phone:956-630-0072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-06
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141300363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care