Healthcare Provider Details

I. General information

NPI: 1780123893
Provider Name (Legal Business Name): DM PROPERTIES OF LAFAYETTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2017
Last Update Date: 02/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2705 HIGHWAY 28 E
PINEVILLE LA
71360-5712
US

IV. Provider business mailing address

3601 JACKSON ST EXT
ALEXANDRIA LA
71303-3002
US

V. Phone/Fax

Practice location:
  • Phone: 318-704-6770
  • Fax: 318-704-6771
Mailing address:
  • Phone: 318-787-6877
  • Fax: 318-787-6896

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. DEEPAK SHARMA
Title or Position: OWNER
Credential: MD
Phone: 318-704-6770