Healthcare Provider Details

I. General information

NPI: 1134530470
Provider Name (Legal Business Name): LAKE CHARLES URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2014
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 RYAN ST
LAKE CHARLES LA
70601-7322
US

IV. Provider business mailing address

1905 COUNTRY CLUB RD
LAKE CHARLES LA
70605-5203
US

V. Phone/Fax

Practice location:
  • Phone: 337-990-8001
  • Fax: 225-214-9349
Mailing address:
  • Phone: 337-990-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MELVIN J MARQUE
Title or Position: OWNER/MEDICAL DIRECTOR
Credential:
Phone: 337-990-8000