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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