| NPI | 1023291226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE BREARD Vice President 318-361-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 207Y00000X Otolaryngology | |
| 208000000X Pediatrics | |
| 208600000X Surgery | |
| 208800000X Urology | |
| 225100000X Physical Therapist | |
| 1041C0700X Social Worker, Clinical | |
| 133V00000X Dietitian, Registered | |
| 183500000X Pharmacist | |
| Enumeration Date | 2007-12-11 |
| Last Update Date | 2023-09-08 |