Healthcare Provider Details

I. General information

NPI: 1528331089
Provider Name (Legal Business Name): OUR LADY OF LOURDES REGIONAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2012
Last Update Date: 02/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 BENDEL RD SUITE A
LAFAYETTE LA
70503-2922
US

IV. Provider business mailing address

4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE LA
70508-6917
US

V. Phone/Fax

Practice location:
  • Phone: 337-232-5864
  • Fax: 337-234-6887
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number10540R
License Number StateLA

VIII. Authorized Official

Name: DR. RICHARD HSIN FEI
Title or Position: DIRECTOR
Credential: MD
Phone: 337-232-5864