Provider Demographics
NPI:1790532711
Name:LARSEN, ASPEN LANCASTER
Entity type:Individual
Prefix:
First Name:ASPEN
Middle Name:LANCASTER
Last Name:LARSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6807 PINEHEARTH CT
Mailing Address - Street 2:
Mailing Address - City:KLEIN
Mailing Address - State:TX
Mailing Address - Zip Code:77379-8498
Mailing Address - Country:US
Mailing Address - Phone:307-389-3753
Mailing Address - Fax:
Practice Address - Street 1:16333 HAFER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-4412
Practice Address - Country:US
Practice Address - Phone:281-537-0211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program