Provider Demographics
NPI:1841771086
Name:LAKIERE PIMENTEL, ARSEEN IVAN (SA-C)
Entity Type:Individual
Prefix:
First Name:ARSEEN
Middle Name:IVAN
Last Name:LAKIERE PIMENTEL
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3749 WILLIAM DEHAES DR APT 401
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-8908
Mailing Address - Country:US
Mailing Address - Phone:469-600-3042
Mailing Address - Fax:
Practice Address - Street 1:3749 WILLIAM DEHAES DR APT 401
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-8908
Practice Address - Country:US
Practice Address - Phone:469-600-3042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-26
Last Update Date:2018-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18-357246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant