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

Lake Jackson Urology PA

Organization Urology Physician · NPI 1558462812

Lake Jackson Urology PA is an Urology Physician in Lake Jackson, Texas. Registered with an NPI since 2006.

In the registry since
2006
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

188 Abner Jackson Pkwy
Lake Jackson, TX 77566-5160
Phone: (979) 297-9488
Fax: (979) 297-9185
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X

Record details

NPI number1558462812
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Philmore Blake — President · (979) 297-9488
NPI enumeratedSeptember 26, 2006
Last updated in NPPESAugust 22, 2020
Mailing address188 Abner Jackson Pkwy, Lake Jackson, TX 77566-5160

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