Organization
LAKE AREA PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK S ROBINSON MD (OWNER)
(936) 582-5620
Entity
Organization
Contact information
Practice address
18057 HWY 105 WEST, STE. 220, MONTGOMERY, TX 77356
(936) 582-5620
(936) 582-5621
Mailing address
18057 HWY 105 WEST, STE. 220, MONTGOMERY, TX 77356
(936) 582-5620
(936) 582-5621
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L3800
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158814702
—
TX
01
—
1740276856
INDIVIDUAL NPI
TX
Enumeration date
08/10/2006
Last updated
01/06/2011
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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