Healthcare Provider Details

I. General information

NPI: 1932161718
Provider Name (Legal Business Name): TECHE DIAGNOSTIC IMAGING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 NORTHWEST BLVD
FRANKLIN LA
70538-3409
US

IV. Provider business mailing address

PO BOX 357
JENNINGS LA
70546-0357
US

V. Phone/Fax

Practice location:
  • Phone: 337-828-9729
  • Fax: 337-828-9740
Mailing address:
  • Phone: 337-828-4403
  • Fax: 337-824-9731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: CLARENCE VAPPIE
Title or Position: ADMINISTRATOR
Credential:
Phone: 337-828-9729