Healthcare Provider Details

I. General information

NPI: 1386571818
Provider Name (Legal Business Name): TWO HEARTS PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 SENATOR PICARD DR
MAURICE LA
70555-3781
US

IV. Provider business mailing address

110 SENATOR PICARD DR
MAURICE LA
70555-3781
US

V. Phone/Fax

Practice location:
  • Phone: 337-230-8009
  • Fax:
Mailing address:
  • Phone: 337-230-8009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SARAH JONES
Title or Position: OWNER
Credential:
Phone: 337-230-8009