| NPI | 1063862340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANNA CRUEY ROARK Facility Administrator 318-212-0552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA MD.016818) |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2016-06-16 |