Healthcare Provider Details

I. General information

NPI: 1033070180
Provider Name (Legal Business Name): HOUMA ORTHOPEDIC CLINIC AMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 MARYLAND DR
LULING LA
70070-2163
US

IV. Provider business mailing address

1001 SCHOOL ST
HOUMA LA
70360-4691
US

V. Phone/Fax

Practice location:
  • Phone: 985-868-1540
  • Fax: 985-873-2968
Mailing address:
  • Phone: 985-868-1540
  • Fax: 985-873-2968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SHAWN TEMPLET
Title or Position: CONTROLLER
Credential:
Phone: 985-868-1540