# LAKEVIEW ENT, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154743227
- **Authorized official:** KYLE KENNEDY M.D. (PRESIDENT)
- **Authorized official phone:** (806) 674-8261

## Contact information

- **Practice address:** 6301 GASTON AVE, DALLAS, TX 75214-3922
- **Practice address phone:** (806) 674-8261
- **Practice address fax:** (214) 691-8292
- **Mailing address:** PO BOX 181022, DALLAS, TX 75218-8022
- **Mailing address phone:** (806) 674-8261
- **Mailing address fax:** (214) 691-8292

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | K0325 | TX | Yes |

## Other

- **Enumeration date:** 01/09/2014
- **Last updated:** 01/09/2014