Terry Lively Enterprises
NPI #1336911387 in Canyon Lake, Texas
Provider Information
- NPI Number
- 1336911387
- Entity Type
- Organization
- Organization Name
- Terry Lively Enterprises
- Primary Specialty
- Specialist/Technologist, Other
- Enumeration Date
- Oct 24, 2023
- Last Updated
- Nov 30, 2023
Practice Location
- Address
- 1478 FM 2673
- City
- Canyon Lake
- State
- Texas
- ZIP Code
- 78133-4583
- Phone
- (210) 585-8410
Authorized Official
- Name
- TERRY LIVELY
- Title
- OWNER
- Phone
- (210) 862-3087
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist, Other |
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