Healthcare Provider Details

I. General information

NPI: 1912372236
Provider Name (Legal Business Name): JAMES MEJIAS M.A., PLPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2015
Last Update Date: 12/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 RIVERSIDE DR
MONROE LA
71201-6211
US

IV. Provider business mailing address

133 JOSEPH THOMAS RD
CALHOUN LA
71225-9734
US

V. Phone/Fax

Practice location:
  • Phone: 318-805-1445
  • Fax:
Mailing address:
  • Phone: 318-805-1445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: