| Lakeside Healthcare | |
|
1512 North Brazos Whitney TX 76692 | |
| (254) 694-6871 | |
| (254) 694-6876 |
| Full Name | Lakeside Healthcare |
|---|---|
| Speciality | Family Medicine |
| Location | 1512 North Brazos, Whitney, Texas |
| Authorized Official Name and Position | Dianna L Anderson (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Contact | 2546946871 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Healthcare 1512 North Brazos Whitney TX 76692 Ph: (254) 694-6871 | Lakeside Healthcare 1512 North Brazos Whitney TX 76692 Ph: (254) 694-6871 |
| NPI Number | 1043402308 |
|---|---|
| Provider Enumeration Date | 08/10/2007 |
| Last Update Date | 09/30/2010 |
| Medicare PECOS PAC ID | 9335291426 |
|---|---|
| Medicare Enrollment ID | O20090721000595 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043402308 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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