Active Health Physical Medicine, Pllc

NPI #1386003259 in Benbrook, Texas

Provider Information

NPI Number: 1386003259
Entity Type: Organization
Organization Name: Active Health Physical Medicine, Pllc
Primary Specialty: General Practice
Enumeration Date: Feb 19, 2016
Last Updated: Feb 19, 2016

Practice Location

Address: 6431 SOUTHWEST BLVD
City: Benbrook
State: Texas
ZIP Code: 76132-2777
Phone: (817) 738-9777

Authorized Official

Name: DR. ELIAS LARA, DO
Title: SOLE MBR
Phone: (817) 738-9777

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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