Organization
LAKE MANAGEMENT GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALICIA ESCOBAR DOVER (PRESIDENT)
(210) 831-4131
Entity
Organization
Contact information
Practice address
127 AUGUSTA DR, WIMBERLEY, TX 78676-2515
(210) 831-4131
Mailing address
127 AUGUSTA DR, WIMBERLEY, TX 78676-2515
(210) 831-4131
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/30/2010
Last updated
01/30/2010
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