Healthcare Provider Details

I. General information

NPI: 1396206223
Provider Name (Legal Business Name): FAMILY SOLUTIONS PEDIATRICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 KILPATRICK BLVD
MONROE LA
71201-5157
US

IV. Provider business mailing address

1105 HUDSON LN
MONROE LA
71201-6003
US

V. Phone/Fax

Practice location:
  • Phone: 318-582-1414
  • Fax:
Mailing address:
  • Phone: 318-322-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. ASHLEY HENDRIX
Title or Position: BUSINESS DEVELOPMENT MANAGER
Credential:
Phone: 318-322-6500