| Lake Jackson Family Practice, Pa | |
|
14450 Tc Jester Blvd. Suite 100 Houston TX 77014 | |
| (281) 292-1121 | |
| Not Available |
| Full Name | Lake Jackson Family Practice, Pa |
|---|---|
| Speciality | Orthopaedic Surgery - Orthopaedic Surgery Of The Spine |
| Location | 14450 Tc Jester Blvd. Suite 100, Houston, Texas |
| Authorized Official Name and Position | Saqib A Siddiqui (MD/PRESIDENT) |
| Authorized Official Contact | 2812921121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Jackson Family Practice, Pa 14450 Tc Jester Blvd. Suite 100 Houston TX 77014 Ph: (281) 292-1121 | Lake Jackson Family Practice, Pa 14450 Tc Jester Blvd. Suite 100 Houston TX 77014 Ph: (281) 292-1121 |
| NPI Number | 1568691327 |
|---|---|
| Provider Enumeration Date | 07/14/2009 |
| Last Update Date | 05/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568691327 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | N3996 (Texas) | Secondary |
| 207XS0117X | Orthopaedic Surgery - Orthopaedic Surgery Of The Spine | M9431 (Texas) | Primary |
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