Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lake Jackson Clinic, PA

Organization Family Medicine Physician · NPI 1205830668

Lake Jackson Clinic, PA is a Family Medicine Physician in Lake Jackson, Texas. Licensed in Texas. Registered with an NPI since 2005.

Licensed in
TX
In the registry since
2005
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

101A Parking Way St
Lake Jackson, TX 77566-5228
Phone: (979) 297-2441
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence E6263 (TX)

Record details

NPI number1205830668
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Liem Bui — President · (979) 297-2441
NPI enumeratedJune 13, 2005
Last updated in NPPESAugust 22, 2020
Mailing address101a Parking Way St, Lake Jackson, TX 77566-5228

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