Provider Demographics
NPI:1528869344
Name:LAKEVIEW FAMILY HEALTH CLINIC
Entity type:Organization
Organization Name:LAKEVIEW FAMILY HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN FNP-C
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:EKUIRELE
Authorized Official - Last Name:ORIWO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN FNP-C
Authorized Official - Phone:972-890-6688
Mailing Address - Street 1:3019 HIDEAWAY DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-0432
Mailing Address - Country:US
Mailing Address - Phone:972-890-6688
Mailing Address - Fax:
Practice Address - Street 1:5900 BALCONES DR STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4298
Practice Address - Country:US
Practice Address - Phone:972-890-6688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care