Provider Demographics
NPI:1083195804
Name:LAKEWOOD ANESTHESIA, PLLC
Entity Type:Organization
Organization Name:LAKEWOOD ANESTHESIA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HOCKERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-335-9165
Mailing Address - Street 1:5706 E MOCKINGBIRD LN STE 115-46
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-5460
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5706 E MOCKINGBIRD LN STE 115-46
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-5460
Practice Address - Country:US
Practice Address - Phone:817-516-8811
Practice Address - Fax:817-516-8444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-29
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty