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General NPI Number Information
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NPI Number | 1336022441
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Entity Type | Organization
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Legal Business Name | LAKESIDE MEDICAL
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 4854 FM1488
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City | CONROE
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State | TX
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Zip | 77384
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Country | US
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Telephone | 713-408-5827
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Fax |
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Provider Business Mailing Address
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Address Line | 51 QUAIL ROCK PL
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City | SPRING
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State | TX
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Zip | 77381-5225
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Country | US
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Telephone | 713-908-5827
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | AMRIT KAUR
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Credential |
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Telephone | 713-908-5827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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