Organization
LAKE POINTE PEDIATRIC ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAMELA MARION MARGARET WIELAND M.D. (PRESIDENT)
(972) 412-1034
Entity
Organization
Contact information
Practice address
6900 SCENIC DRIVE, SUITE 103, ROWLETT, TX 75088-2695
(972) 412-1034
(972) 475-5708
Mailing address
6900 SCENIC DRIVE, SUITE 103, ROWLETT, TX 75088-2695
(972) 412-1034
(972) 475-5708
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K5394
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0036CV
BLUE CROSS OF TEXAS
TX
Enumeration date
10/02/2006
Last updated
08/22/2020
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