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General NPI Number Information
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NPI Number | 1528869344
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Entity Type | Organization
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Legal Business Name | LAKEVIEW FAMILY HEALTH CLINIC
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Dates
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Enumeration Date | 03/19/2025
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 5900 BALCONES DR STE 100
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City | AUSTIN
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State | TX
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Zip | 78731-4298
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Country | US
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Telephone | 972-890-6688
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Fax |
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Provider Business Mailing Address
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Address Line | 3019 HIDEAWAY DR
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-0432
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Country | US
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Telephone | 972-890-6688
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Fax |
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Authorized Official
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Title or Position | APRN FNP-C
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Name | THERESA EKUIRELE ORIWO
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Credential | APRN FNP-C
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Telephone | 972-890-6688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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