| NPI | 1104025048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN XUAN NGUYEN Medical Director 318-648-0375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD 204738) |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2019-06-26 |