NPI 1851489520

Lakeside Surgery, P.A.

Organisation Specialist Rockwall, TX

Practice location

Address: 3142 Horizon Rd Suite 206, Rockwall, TX 75032-7809
Phone: (972) 722-3290
Fax: (469) 402-2585
Mailing address: 2850 Shoreline Trl Pmb 154, Rockwall, TX 75032-5508

Authorised official

Name: Katherine R Makohon
Title: Surgeon/Owner
Phone: (972) 722-3290

Registered specialties (3)

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence K6483 (TX)

Other Specialist providers in Texas →

Specialist

Other Service Providers Taxonomy 174400000X Licence J2983 (TX)

Specialist

Other Service Providers Taxonomy 174400000X Licence P6593 (TX)

Registry record

NPI: 1851489520
Entity type: Organization
NPI issued: 10 Oct 2006
Record last updated: 7 Jun 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.