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General NPI Number Information
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NPI Number | 1811885288
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Entity Type | Organization
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Legal Business Name | LAKESIDE FAMILY HEALTH CARE PLLC
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 6701 HERITAGE PKWY STE 165
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City | ROCKWALL
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State | TX
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Zip | 75087-8700
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Country | US
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Telephone | 972-460-3500
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Fax | 972-460-3501
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Provider Business Mailing Address
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Address Line | 9330 LBJ FWY STE 800
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City | DALLAS
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State | TX
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Zip | 75243-4310
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Country | US
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Telephone | 972-792-5700
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Fax | 214-506-1170
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH VU
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Credential | DO
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Telephone | 214-762-2216
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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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