Lake Jackson Urology PA
NPI #1558462812 in Lake Jackson, Texas
Provider Information
- NPI Number
- 1558462812
- Entity Type
- Organization
- Organization Name
- Lake Jackson Urology PA
- Primary Specialty
- Urology
- Enumeration Date
- Sep 26, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 188 ABNER JACKSON PKWY
- City
- Lake Jackson
- State
- Texas
- ZIP Code
- 77566-5160
- Phone
- (979) 297-9488
Authorized Official
- Name
- DR. PHILMORE BLAKE
- Title
- PRESIDENT
- Phone
- (979) 297-9488
Specialties & Taxonomy Codes
| Specialty |
|---|
| Urology |
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