| NPI | 1902186000 |
|---|---|
| Other Name | LAKE JACKSON VA CBOC |
| Entity Type | Organization |
| Authorized Contact | ERIN POTTER Npi Team Member 202-382-2579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA |
| Enumeration Date | 2011-08-19 |
| Last Update Date | 2017-09-29 |