| Lakeside Gastroenterology And Liver Specialists, Pllc | |
|
690 S Loop 336 W Ste 215 Conroe TX 77304-3322 | |
| (936) 828-3962 | |
| Not Available |
| Full Name | Lakeside Gastroenterology And Liver Specialists, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 690 S Loop 336 W Ste 215, Conroe, Texas |
| Authorized Official Name and Position | Nelson A Tajong (OWNER) |
| Authorized Official Contact | 4105305310 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Gastroenterology And Liver Specialists, Pllc 86 Lenox Hill Dr Spring TX 77382-2527 Ph: () - | Lakeside Gastroenterology And Liver Specialists, Pllc 690 S Loop 336 W Ste 215 Conroe TX 77304-3322 Ph: (936) 828-3962 |
| NPI Number | 1033439781 |
|---|---|
| Provider Enumeration Date | 06/04/2010 |
| Last Update Date | 10/29/2020 |
| Medicare PECOS PAC ID | 6507981651 |
|---|---|
| Medicare Enrollment ID | O20100914000402 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033439781 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Michael Warren Robles |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1427034495 PECOS PAC ID: 7618947334 Enrollment ID: I20040729001021 |
| Provider Name | Nelson Atembe Tajong |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1760436182 PECOS PAC ID: 3173571890 Enrollment ID: I20060726000328 |
| Provider Name | Ndeloke Lauduine Tajong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861162406 PECOS PAC ID: 4587191424 Enrollment ID: I20241217001740 |
| Provider Name | Elise Jeanne Meeks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922668045 PECOS PAC ID: 4385073428 Enrollment ID: I20250301000168 |
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