Healthcare Provider Details

I. General information

NPI: 1366111791
Provider Name (Legal Business Name): SWLA CENTER FOR HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1214 COOLIDGE BLVD
LAFAYETTE LA
70503-2621
US

IV. Provider business mailing address

2000 OPELOUSAS ST
LAKE CHARLES LA
70601-2641
US

V. Phone/Fax

Practice location:
  • Phone: 337-769-9451
  • Fax: 337-769-9460
Mailing address:
  • Phone: 337-439-8898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM BRENT III
Title or Position: CEO
Credential:
Phone: 337-296-9177