MEDICARE: DR. LOUISE M BECNEL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	017638	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MD.017638	OTHER	LA	STATE MEDICAL LICENSE

General Provider Information

NPI Number	:	1518928001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUISE M BECNEL MD

Provider Business Mailing Address
First Line	:	PO BOX 122205 DEPT 2205
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75312-0001
Country	:	US
Telephone Number	:	337-494-2772
Fax Number	:	337-494-2928

Provider Business Practice Location Address
First Line	:	2770 3RD AVE STE 300
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-8994
Country	:	US
Telephone Number	:	337-494-6800
Fax Number	:	337-494-4696

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2006
Last Update Date	:	04/27/2022

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