Provider Demographics
NPI:1407817521
Name:LAKEPOINTE PET
Entity type:Organization
Organization Name:LAKEPOINTE PET
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-488-7226
Mailing Address - Street 1:PO BOX 1998
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73101-1998
Mailing Address - Country:US
Mailing Address - Phone:405-488-7226
Mailing Address - Fax:405-418-0118
Practice Address - Street 1:10914 HEFNER POINTE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-5066
Practice Address - Country:US
Practice Address - Phone:405-488-7226
Practice Address - Fax:405-418-0188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology