Lake Jackson Clinic, P.a.

NPI 1205830668 - Family Medicine - 207Q00000X

NPI Details
NPI 1205830668
Enumeration Date 06/13/2005
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name LIEM P LIEM
Position PRESIDENT
Phone (979) 297-2441
Fax
Practice Location
101A PARKING WAY ST
LAKE JACKSON TX, 77566-5228, US
Phone (979) 297-2441
Fax
Business Location
101A PARKING WAY ST
LAKE JACKSON TX, 77566-5228, US
Phone
Fax
Toxanomy
Taxonomy Code 207Q00000X
License State Texas
License Number E6263
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According to our database, Lake Jackson Clinic, P.a. NPI is 1205830668, taxonomy code is 207Q00000X and license number is E6263, license state is located at Texas. Lake Jackson Clinic, P.a. physically located at 101a Parking Way St, Lake Jackson TX, 77566-5228. NPI Number 1033115704 has the healthcare provider type.

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1205830668 NPI number is provided on an as is basis without warranty of any kind. 1205830668 is maintained by the National Plan & Provider Enumeration System. The contents of Lake Jackson Clinic, P.a. are for informational purposes only.