Healthcare Provider Details

I. General information

NPI: 1750810016
Provider Name (Legal Business Name): TANIA MULTANI KOHAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2017
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8120 MAIN ST STE 401
HOUMA LA
70360-3403
US

IV. Provider business mailing address

8120 MAIN ST STE 401
HOUMA LA
70360-3403
US

V. Phone/Fax

Practice location:
  • Phone: 985-850-6090
  • Fax:
Mailing address:
  • Phone: 985-850-6090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number322513
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number322513
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: