Healthcare Provider Details

I. General information

NPI: 1831244375
Provider Name (Legal Business Name): BOPP DERMATOLOGY AND FACIAL PLASTIC SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3421 N CAUSEWAY BLVD SUITE 102
METAIRIE LA
70002-3733
US

IV. Provider business mailing address

3421 N CAUSEWAY BLVD SUITE 102
METAIRIE LA
70002-3733
US

V. Phone/Fax

Practice location:
  • Phone: 504-455-9933
  • Fax: 504-888-8221
Mailing address:
  • Phone: 504-455-9933
  • Fax: 504-888-8221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: SUELYNN RESENDEZ
Title or Position: OFFICE MANAGER
Credential:
Phone: 504-455-9933