Organization
MCKENNA MEDICAL GROUP
Active
Organization
MCKENNA MEDICAL GROUP
Active
Other names
LAKEVIEW CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WENDY BRUNS (V.P. PHYSICIAN SERVICES)
(830) 606-9111
Entity
Organization
Contact information
Practice address
921 LAKEVIEW BLVD, NEW BRAUNFELS, TX 78130-4135
(210) 620-7744
Mailing address
921 LAKEVIEW BLVD, NEW BRAUNFELS, TX 78130-4135
(210) 620-7744
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
524221
NON-PROFIT HEALTH ORGANIZ
TX
01
—
OOY940
PTAN
TX
Enumeration date
02/26/2007
Last updated
05/12/2008
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