# LAKE JACKSON IMAGING CENTER

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

## Provider details

- **NPI number:** 1417968637
- **Authorized official:** DR. JOHN E BUCK M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (936) 203-5996

## Contact information

- **Practice address:** 217 OAK DRIVE SOUTH SUITE A, LAKE JACKSON, TX 77566
- **Practice address phone:** (979) 297-2800
- **Mailing address:** 217 OAK DR S, SUITE A, LAKE JACKSON, TX 77566-5675
- **Mailing address phone:** (979) 297-2800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | TX | Yes |

## Other

- **Enumeration date:** 08/11/2006
- **Last updated:** 10/16/2008