Healthcare Provider Details

I. General information

NPI: 1578411286
Provider Name (Legal Business Name): MABRY WOMENS HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13059 ROYAL OAK DR
HAMMOND LA
70403-3221
US

IV. Provider business mailing address

13059 ROYAL OAK DR
HAMMOND LA
70403-3221
US

V. Phone/Fax

Practice location:
  • Phone: 985-320-7910
  • Fax: 985-542-7010
Mailing address:
  • Phone: 985-320-7910
  • Fax: 985-542-7010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DWAN SHIRMELLE MABRY
Title or Position: PRACTICE MANAGER
Credential: MD
Phone: 985-320-7910