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Organization
LAKE JACKSON CLINIC, P.A.
Active
Organization
LAKE JACKSON CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LIEM P BUI M.D. (PRESIDENT)
(979) 297-2441
Entity
Organization
Contact information
Practice address
101A PARKING WAY ST, LAKE JACKSON, TX 77566-5228
(979) 297-2441
Mailing address
101A PARKING WAY ST, LAKE JACKSON, TX 77566-5228
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E6263
TX
Other
Enumeration date
06/13/2005
Last updated
08/22/2020
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