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Organization
LAKESIDE MEDICAL ASSOCIATES, P. A.
Active
Organization
LAKESIDE MEDICAL ASSOCIATES, P. A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY VOLLENWEIDER (PRESIDENT)
(972) 625-7000
Entity
Organization
Contact information
Practice address
6053 MAIN ST, SUITE 130, THE COLONY, TX 75056-4706
(972) 625-7000
(972) 625-8787
Mailing address
6053 MAIN ST, SUITE 130, THE COLONY, TX 75056-4706
(972) 625-7000
(972) 625-8787
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
F2507
TX
Other
Enumeration date
05/03/2007
Last updated
01/20/2017
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