| Doctor Name: | JANICE LAKE |
| NPI Number: | 1053419150 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | TECH |
| License Number: | |
| Business Practice Address: | 4124 Gus Thomasson Road Mesquite, TX - 751502226 |
| Business Phone Number: | 9726820484 |
| Business Fax Number: | 2142215600 |
| Mailing Address: | 4124 Gus Thomasson Road, MESQUITE |
| State: | TX |
| Postal Code: | 751502226 |
| Phone Number: | 9726820484 |
| Fax Number: | 2142215600 |
| NPI Enumeration Date: | 09/20/2006 |
| NPI Last Update Date: | 12/06/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471S1302X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Sonography |
| Taxonomy Definition: | |