Healthcare Provider Details

I. General information

NPI: 1720195712
Provider Name (Legal Business Name): ESCIPION PEDROZA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4213 SAXON ST SUITE 200
METAIRIE LA
70006-4187
US

IV. Provider business mailing address

4213 SAXON ST SUITE 200
METAIRIE LA
70006-4187
US

V. Phone/Fax

Practice location:
  • Phone: 504-454-2816
  • Fax: 504-455-5684
Mailing address:
  • Phone: 504-454-2816
  • Fax: 504-455-5684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. TERRY L BOZEMAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 504-454-2260