Healthcare Provider Details

I. General information

NPI: 1528687233
Provider Name (Legal Business Name): NUSRAT KABIR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2020
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 ASTER ST
LAKE CHARLES LA
70601-8824
US

IV. Provider business mailing address

PO BOX 122539 DEPT 2539
DALLAS TX
75312-0001
US

V. Phone/Fax

Practice location:
  • Phone: 337-480-8900
  • Fax:
Mailing address:
  • Phone: 337-494-2921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number342960
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: