| NPI | 1952817843 |
|---|---|
| Doing Business As | LAKESIDE EYE GROUP |
| Entity Type | Organization |
| Authorized Contact | GEORGE L NEAL Chief Executive Officer 469-214-0144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2020-02-05 |