Healthcare Provider Details

I. General information

NPI: 1073755872
Provider Name (Legal Business Name): GAD PSYCHIATRIC GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2009
Last Update Date: 04/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 ASMA BLVD SUITE 112
LAFAYETTE LA
70508-3846
US

IV. Provider business mailing address

102 ASMA BLVD SUITE 112
LAFAYETTE LA
70508-3846
US

V. Phone/Fax

Practice location:
  • Phone: 337-504-2332
  • Fax: 337-504-4748
Mailing address:
  • Phone: 337-504-2332
  • Fax: 337-504-4748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number017624
License Number StateLA

VIII. Authorized Official

Name: SARWAT M GAD
Title or Position: PRESIDENT
Credential: MD
Phone: 337-504-2332