Unknown Individual – Family Medicine Physician, NPI 1891716858
Family Medicine Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
201 THAT WAY ST
LAKE JACKSON, TX 77566
Phone: (979) 285-2100
Fax: (979) 297-0200
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 77566)
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