ALTUS LAKE JACKSON LP NPI 1275957508

NPI Information

NPI: 1275957508
Provider Name: ALTUS LAKE JACKSON, LP

Other Name: ALTUS MANAGEMENT LLC GEN PTR

Classification: Clinic/Center - 261QE0002X
Entity Type: Organization

Specialization: Emergency Care

CLIA Number: 45D2069850

Address:
200 OAK DRIVE SOUTH
LAKE JACKSON, TX
ZIP 77566
Phone: (409) 981-5580
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ALTUS LAKE JACKSON, LP is an emergency care clinic center in Lake Jackson, TX. ALTUS LAKE JACKSON, LP NPI is 1275957508. The provider is registered as an organization entity type.
The provider Other Name Is Altus Management Llc Gen Ptr.

The provider's business location address is:

200 OAK DRIVE SOUTH
LAKE JACKSON, TX
ZIP 77566-628
Phone: (409) 981-5580
Fax: (409) 981-5501

The provider's authorized official is Lauren Cotton .
The authorized official title is Chief Operations Officer and has the following contact phone number (832) 219-3833.

The CLIA number assigned to this NPI record is 45D2069850 - other - free standing er with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 2/6/2014 and was last updated on 3/8/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0002X	Clinic/Center	Emergency Care			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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