Provider Demographics
NPI:1831397587
Name:MORGAN, LARISA VASILYEVNA (RN, MSN, PNCP)
Entity type:Individual
Prefix:MRS
First Name:LARISA
Middle Name:VASILYEVNA
Last Name:MORGAN
Suffix:
Gender:F
Credentials:RN, MSN, PNCP
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Mailing Address - Street 1:3066 E COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78220-1013
Mailing Address - Country:US
Mailing Address - Phone:210-233-7062
Mailing Address - Fax:210-228-0065
Practice Address - Street 1:8210 CALLAGHAN RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4775
Practice Address - Country:US
Practice Address - Phone:210-233-7000
Practice Address - Fax:210-348-9930
Is Sole Proprietor?:No
Enumeration Date:2007-07-04
Last Update Date:2018-01-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX710255363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics