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Lake Jackson Plastic Surgery, Pa
Medical Specialty Clinic/Center in Lake Jackson, Texas
NPI 1912259698

Lake Jackson Plastic Surgery, Pa is a Medical Specialty Clinic/Center based in Houston, TX and is specialized in Medical Specialty. Lake Jackson Plastic Surgery, Pa practices in Lake Jackson, TX. The NPI Number for Lake Jackson Plastic Surgery, Pa is 1912259698 and holds a License No. H2191 (Texas).

The current practice location address for Lake Jackson Plastic Surgery, Pa is 215 Oak Dr S, Lake Jackson, TX and can be reached out via phone at 979-480-0105 and via fax at 979-480-0106.

Location: 215 Oak Dr S, Lake Jackson, TX, 77024-1007
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1912259698
Provider Name
Lake Jackson Plastic Surgery, Pa
Credential
Provider Entity Type
Organization
Address
215 Oak Dr S, Lake Jackson, TX, 77024-1007
Phone Number
979-480-0105
Fax Number
979-480-0106
Provider Enumeration Date
10/05/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
215 Oak Dr S
City
Lake Jackson
State
Texas
Zip
77566-5629
Phone Number
979-480-0105
Fax Number
979-480-0106
person
Provider Business Mailing Address Details
Address
215 Oak Dr S
City
Lake Jackson
State
Texas
Zip
77566-5629
Phone Number
979-480-0105
Fax Number
979-480-0106
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
H2191 (Texas)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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