Healthcare Provider Details

I. General information

NPI: 1992945141
Provider Name (Legal Business Name): FASTRAC URGENT CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2009
Last Update Date: 02/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5991 BULLARD AVE SUITE B
NEW ORLEANS LA
70128-2817
US

IV. Provider business mailing address

5991 BULLARD AVE SUITE B
NEW ORLEANS LA
70128-2817
US

V. Phone/Fax

Practice location:
  • Phone: 504-241-0106
  • Fax:
Mailing address:
  • Phone: 504-241-0106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberAP5482
License Number StateLA

VIII. Authorized Official

Name: DR. TAMLA THOMAS PIERRE
Title or Position: CEO
Credential: APRN
Phone: 504-241-0106