Individual
JOEL MICKAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 MEDICAL DR, LAKE JACKSON, TX 77566-5674
(979) 285-1984
Mailing address
100 MEDICAL DR, LAKE JACKSON, TX 77566-5674
(979) 285-1984
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA06800
TX
Other
Enumeration date
06/03/2010
Last updated
07/18/2010
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