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Organization
LAGO MAR MEDICAL CLINIC LLC
Active
Organization
LAGO MAR MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABIOLA OPABUNMI NP (NP/OWNER)
(409) 944-8513
Entity
Organization
Contact information
Practice address
2709 PALMER HWY, TEXAS CITY, TX 77590-6929
(409) 944-8513
(409) 299-3773
Mailing address
2709 PALMER HWY, TEXAS CITY, TX 77590-6929
(409) 944-8513
(409) 299-3773
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
363LX0106X
Occupational Health Nurse Practitioner
—
NULL
363LX0106X
Occupational Health Nurse Practitioner
—
—
Other
Enumeration date
10/24/2019
Last updated
05/01/2026
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