Healthcare Provider Details

I. General information

NPI: 1013313402
Provider Name (Legal Business Name): BAYOU URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2014
Last Update Date: 11/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 FAIRWAY DR
NEW ORLEANS LA
70124-1020
US

IV. Provider business mailing address

901 W JUDGE PEREZ DR
CHALMETTE LA
70043-4701
US

V. Phone/Fax

Practice location:
  • Phone: 504-237-4696
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GREG FERNANDEZ
Title or Position: OWNER
Credential: MD
Phone: 505-237-4696