Medina Lake Clinic PA

NPI #1811274525 in Lakehills, Texas

Provider Information

NPI Number
1811274525
Entity Type
Organization
Organization Name
Medina Lake Clinic PA
Primary Specialty
Family Medicine
Enumeration Date
Nov 9, 2011
Last Updated
Mar 13, 2012

Practice Location

Address
146 LAUREL VISTA DR
State
Texas
ZIP Code
78063-6389
Phone
(713) 292-6959

Authorized Official

Name
SHELLY KOHLLEPPEL, MD
Title
OWNER
Phone
(830) 751-3330

Specialties & Taxonomy Codes

Specialty
Family Medicine

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