| Lake Lewisville Pediatrics, Llp | |
|
2141 S Edmonds Ln Lewisville TX 75067-6162 | |
| (972) 315-8500 | |
| Not Available |
| Full Name | Lake Lewisville Pediatrics, Llp |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2141 S Edmonds Ln, Lewisville, Texas |
| Authorized Official Name and Position | John Glen Ogden (MD) |
| Authorized Official Contact | 9723158500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Lewisville Pediatrics, Llp 2141 S Edmonds Ln Lewisville TX 75067-6162 Ph: (972) 315-8500 | Lake Lewisville Pediatrics, Llp 2141 S Edmonds Ln Lewisville TX 75067-6162 Ph: (972) 315-8500 |
| NPI Number | 1649471814 |
|---|---|
| Provider Enumeration Date | 05/29/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649471814 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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