| NPI | 1043317514 |
|---|---|
| Doing Business As | LAKESIDE MEDICAL CLINC |
| Entity Type | Organization |
| Authorized Contact | JOHN EDWARD PERRY President 936-760-1691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX L 1430) |
| Enumeration Date | 2006-09-19 |
| Last Update Date | 2020-08-22 |