Organization
LAKESIDE HOSPITAL AT BASTROP, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEGGY BORGFELD (DIRECTOR OF ACCOUNTING)
(512) 321-8200
Entity
Organization
Contact information
Practice address
3201 HIGHWAY 71 E, BASTROP, TX 78602-5126
(512) 321-8200
(512) 321-8701
Mailing address
3201 HIGHWAY 71 E, BASTROP, TX 78602-5126
(512) 321-8200
(512) 321-8701
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
008314
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181544101
—
TX
01
—
HH1113
TEXAS BLUECROSS
—
05
—
PENDING
—
TX
Enumeration date
07/07/2006
Last updated
12/16/2008
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