Lake, Janice

Lake, Janice is an individual health care provider with primary practice located at 4124 Gus Thomasson Road , Mesquite TX 75150-2226. She recently has 2 registered licenses in different health care specialties including Technologists, Technicians & Other Technical Service Providers / Radiography, Technologists, Technicians & Other Technical Service Providers / Sonography. Technologists, Technicians & Other Technical Service Providers / Radiography is her primary health care specialty. Lake, Janice can be contacted via phone (972) 682-0484.

Contact Information

Primary practice address
4124 Gus Thomasson Road Mesquite TX 75150-2226
Phone: (972) 682-0484
Fax: (214) 221-5600
Website:
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Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Radiography 2471C3402X Texas
Technologists, Technicians & Other Technical Service Providers / Sonography 2471S1302X Texas

Profile Details

NPI number 1053419150
LBN Legal business name Lake, Janice
Credentials TECH
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Dec 6th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053419150 NPPES
Texas Other 459840 BCBS

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