| NPI | 1497090740 |
|---|---|
| Doing Business As | OUR LADY OF THE LAKE PONTCHARTRAIN SURGERY CENTER |
| Entity Type | Organization |
| Authorized Contact | JENETHA D MORAN Authorized Official 972-763-3893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: LA 157) |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2017-09-06 |