Healthcare Provider Details

I. General information

NPI: 1326976176
Provider Name (Legal Business Name): JAMES PATRICK HEARD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 RYANS WAY
MINDEN LA
71055-4231
US

IV. Provider business mailing address

PO BOX 332
STONEWALL LA
71078-0332
US

V. Phone/Fax

Practice location:
  • Phone: 318-636-8046
  • Fax: 318-636-8036
Mailing address:
  • Phone: 318-636-8046
  • Fax: 318-636-8036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number12305
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: