| NPI | 1851489520 |
|---|---|
| Doing Business As | LAKESIDE SURGERY, P.A. |
| Entity Type | Organization |
| Authorized Contact | KATHERINE R MAKOHON Surgeon/Owner 972-722-3290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX K6483) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX J2983) |
| 174400000X Specialist (Licence: TX P6593) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2013-06-07 |