Healthcare Provider Details

I. General information

NPI: 1457925554
Provider Name (Legal Business Name): DAREEN SARDAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2021
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 ENTERPRISE DR STE B
HOUMA LA
70360-5405
US

IV. Provider business mailing address

605 ENTERPRISE DR STE B
HOUMA LA
70360-5405
US

V. Phone/Fax

Practice location:
  • Phone: 985-262-1639
  • Fax: 985-262-8197
Mailing address:
  • Phone: 985-262-1639
  • Fax: 985-262-8197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD486449
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number352385
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: