| NPI | 1245400779 |
|---|---|
| Other Name | LAKESIDE FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | ROBERT LAWRENCE MAGRUDER Owner 972-463-2991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX G5325) |
| Enumeration Date | 2008-03-12 |
| Last Update Date | 2008-03-12 |