Lakeshore Ent

NPI 1003096991 - Otolaryngology - 207YS0123X

NPI Details
NPI 1003096991
Enumeration Date 11/07/2007
Last Updated 01/07/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name STEPHEN GEORGE STEPHEN
Position OWNER
Phone (817) 573-6673
Fax (817) 573-9783
Practice Location
1305 PALUXY RD
SUITE A
GRANBURY TX, 76048-5641, US
Phone (817) 573-6673
Fax (817) 573-9783
Business Location
1305 PALUXY RD
SUITE A
GRANBURY TX, 76048-5641, US
Phone (817) 573-6673
Fax (817) 573-9783
Toxanomy
Taxonomy Code 207YS0123X
License State Texas
License Number K8272
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According to our database, Lakeshore Ent NPI is 1003096991, taxonomy code is 207YS0123X and license number is K8272, license state is located at Texas. Lakeshore Ent physically located at 1305 Paluxy Rd, Granbury TX, 76048-5641. NPI Number 1033115704 has the healthcare provider type.

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1003096991 NPI number is provided on an as is basis without warranty of any kind. 1003096991 is maintained by the National Plan & Provider Enumeration System. The contents of Lakeshore Ent are for informational purposes only.