| Park Lakes Family Medicine, P.a. | |
|
1305 W. Parkwood Ave Suite A-107 Friendswood TX 77546 | |
| (281) 996-0068 | |
| (281) 996-0186 |
| Full Name | Park Lakes Family Medicine, P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 1305 W. Parkwood Ave, Friendswood, Texas |
| Authorized Official Name and Position | Efrain E Soto (PRESIDENT) |
| Authorized Official Contact | 2819960068 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Lakes Family Medicine, P.a. 1305 W. Parkwood Ave Suite A-107 Friendswood TX 77546-1895 Ph: (281) 996-0068 | Park Lakes Family Medicine, P.a. 1305 W. Parkwood Ave Suite A-107 Friendswood TX 77546 Ph: (281) 996-0068 |
| NPI Number | 1699927947 |
|---|---|
| Provider Enumeration Date | 10/17/2008 |
| Last Update Date | 01/26/2009 |
| Medicare PECOS PAC ID | 9436215704 |
|---|---|
| Medicare Enrollment ID | O20090311000735 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699927947 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | N1900 (Texas) | Primary |
| Provider Name | Efrain E Soto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124229695 PECOS PAC ID: 1254497522 Enrollment ID: I20090311000737 |
| Provider Name | Jamie Lynn Rebando |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265949176 PECOS PAC ID: 8921367772 Enrollment ID: I20180124000794 |
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