| NPI | 1154561223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LLOYD D BELLAH Owner 318-841-2801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA 12606R) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX K0260) |
| Enumeration Date | 2009-03-02 |
| Last Update Date | 2009-03-02 |