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
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