Healthcare Provider Details

I. General information

NPI: 1477674083
Provider Name (Legal Business Name): TRI PARISH PET SCANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8120 MAIN ST
HOUMA LA
70360-3403
US

IV. Provider business mailing address

8120 MAIN ST
HOUMA LA
70360-3403
US

V. Phone/Fax

Practice location:
  • Phone: 985-857-8093
  • Fax: 225-215-1658
Mailing address:
  • Phone: 985-857-8093
  • Fax: 225-215-1658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES K CHAMPAGNE
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 985-857-8093