Healthcare Provider Details

I. General information

NPI: 1710061361
Provider Name (Legal Business Name): NAHLA A DAHR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NAHLA DAHR-MALEK MD

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 05/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 PATTERSON STREET
LAFAYETTE LA
70601
US

IV. Provider business mailing address

2000 OPELOUSAS STREET
LAKE CHARLES LA
70601
US

V. Phone/Fax

Practice location:
  • Phone: 337-769-9451
  • Fax: 337-769-9460
Mailing address:
  • Phone: 337-439-9983
  • Fax: 337-439-3224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number12675R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: