| NPI | 1720620784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY JANE WARD Senior VP Finance 318-212-8951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology |
| Enumeration Date | 2019-10-11 |
| Last Update Date | 2019-10-11 |