MEDICARE: LAKEWOOD FAMILY PHYSICIANS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	H8361	TX
2	207Q00000X	Family Medicine Physician	H7925	TX

General Provider Information

NPI Number	:	1760483218
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKEWOOD FAMILY PHYSICIANS PA

Provider Business Mailing Address
First Line	:	18220 TOMBALL PKWY
Second Line	:	STE 370
City	:	HOUSTON
State	:	TX
Zip	:	77070-4347
Country	:	US
Telephone Number	:	281-469-6667
Fax Number	:	281-469-8567

Provider Business Practice Location Address
First Line	:	18220 TOMBALL PKWY
Second Line	:	STE 370
City	:	HOUSTON
State	:	TX
Zip	:	77070-4347
Country	:	US
Telephone Number	:	281-469-6667
Fax Number	:	281-469-8567

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHELE G BRINKLEY
Credential	:	MD
Telephone Number	:	281-469-6667

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	05/06/2008

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Directions to “LAKEWOOD FAMILY PHYSICIANS PA ” Practice Location

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