| Lago Mar Medical Clinic Llc | |
|
8030 Fm 1765 Ste C-102 Texas City TX 77591-3689 | |
| (409) 515-3915 | |
| (409) 299-3773 |
| Full Name | Lago Mar Medical Clinic Llc |
|---|---|
| Speciality | Family Medicine - Adult Medicine |
| Location | 8030 Fm 1765 Ste C-102, Texas City, Texas |
| Authorized Official Name and Position | Abiola Opabunmi (NP/OWNER) |
| Authorized Official Contact | 4095153915 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lago Mar Medical Clinic Llc 8030 Fm 1765 Ste C-102 Texas City TX 77591-3689 Ph: (409) 515-3915 | Lago Mar Medical Clinic Llc 8030 Fm 1765 Ste C-102 Texas City TX 77591-3689 Ph: (409) 515-3915 |
| NPI Number | 1063055820 |
|---|---|
| Provider Enumeration Date | 10/24/2019 |
| Last Update Date | 10/24/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063055820 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
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