| NPI | 1376949768 |
|---|---|
| Doing Business As | LAKEVISTA PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | BRANDI DOTY Bookkeeper/Manager 985-626-0855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2017-02-17 |