Lake Jackson Clinic, P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E6263 Issued in TX

Legal business name

LAKE JACKSON CLINIC, P.A.

Practice address

101A Parking Way St
Lake Jackson, TX 77566-5228

Phone

(979) 297-2441

NPI assigned

Jun 13, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Liem P Bui, M.D.NPI 1124022967

Title

President

Phone

(979) 297-2441

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thuy-Khanh Ha Bui, D.O.

  • Family Medicine Physician
  • Lake Jackson, TX
  • NPI 1649265372
  Medicare reassignment
• Liem P Bui, M.D.

  • Family Medicine Physician
  • Lake Jackson, TX
  • NPI 1124022967
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205830668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101A PARKING WAY ST",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101A PARKING WAY ST",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665228",
            "telephone_number": "979-297-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE JACKSON CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUI",
        "authorized_official_first_name": "LIEM",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "979-297-2441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "E6263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bailey Victoria Laday
• Amy Catherine Laird-Payne, PYSICIAN ASSISTANT
• Lake Jackson Assisted Living, LTD. (Hearthstone at Lake Jackson)
• Lake Jackson Audiology and Hearing Aid Consultants, LLC (Lake Jackson Audiology)
• Lake Jackson Chiropractic and Rehab PC
• Lake Jackson Dental Care P.a.
• Lake Jackson Dialysis and Kidney Center, LTD, LLP
• Lake Jackson Emergency Medical Services, Inc.
• Lake Jackson Endoscopy Center, LP.
• Lake Jackson Family Dentistry PLLC

• Family Medicine Physician in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.