LAKESIDE SURGERY P.A. NPI 1851489520

NPI Details

LAKESIDE SURGERY, P.A. is a specialist in Rockwall, TX. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. LAKESIDE SURGERY, P.A. NPI is 1851489520. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Lakeside Surgery, P.a..

The provider's business location address is:

3142 HORIZON RD
SUITE 206
ROCKWALL, TX
ZIP 75032-809
Phone: (972) 722-3290
Fax: (469) 402-2585

The provider's authorized official is Katherine R Makohon .
The authorized official title is Surgeon/owner and has the following contact phone number (972) 722-3290.

The enumeration date for this NPI number is 10/10/2006 and was last updated on 6/7/2013.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.