Healthcare Provider Details

I. General information

NPI: 1942341748
Provider Name (Legal Business Name): HOUMA MEDICAL IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 CIVIC CENTER DRIVE
HOUMA LA
70360
US

IV. Provider business mailing address

316 CIVIC CENTER DRIVE
HOUMA LA
70360
US

V. Phone/Fax

Practice location:
  • Phone: 337-981-2277
  • Fax: 337-981-2202
Mailing address:
  • Phone: 337-981-2277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFF RICHARD
Title or Position: MANAGER
Credential:
Phone: 337-981-2277